| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARTY MIRACLE3 | 9811 KATY FREEWAY SUITE 500 HOUSTON, TX 77024 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $173K | — | $173K | 3.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, INC. | ONE INTERNATIONAL PLAZA, 4TH FL PHILADELPHIA, PA 19113 | DELTA DENTAL OF PENNSYLVANIA | $7K | — | $7K | 4.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | P.O. BOX 61187 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $11K | — | $11K | 9.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | P.O. BOX 61187 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 9.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | P.O. BOX 61187 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 9.31% |
| MARTIN R. MIRACLE3 | 13926 MAPLE CLIFF LANE CYPRESS, TX 77429 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $3K | — | $3K | 10.00% |
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 | 468 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 468 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 690 | $168K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 608 | $29K |
| Life insurance | STANDARD INSURANCE COMPANY | 468 | $57K |
| Short-term disability | STANDARD INSURANCE COMPANY | 213 | $122K |
| Long-term disability | STANDARD INSURANCE COMPANY | 155 | $81K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 603 | $4.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 690 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.