| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $20K | $854 | $20K | 1.46% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $41 | $19K | 13.78% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.29% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $236 | $41 | $277 | 0.20% |
| USI INSURANCE SERVICES LLC3 | 1787 SENTRY PARKWAY WEST, SUITE 300 BLUE BELL, PA 19422 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $256 | $256 | 0.19% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | DELTA DENTAL OF MINNESOTA | $3K | $0 | $3K | 3.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MINNESOTA | $848 | $0 | $848 | 0.76% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | DELTA DENTAL OF MINNESOTA | $756 | $0 | $756 | 0.67% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 207 | $1.4M |
| Dental | DELTA DENTAL OF MINNESOTA | 230 | $112K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 246 | $136K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 246 | $136K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 246 | $136K |
| Prescription drug | MEDICA INSURANCE COMPANY | 207 | $1.4M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 246 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.