| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 308 NORTH 21ST STREET ST. LOUIS, MO 63103 | TOKIO MARINE | $37K | — | $37K | 16.32% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNION SECURITY INSURANCE COMPANY | $2K | $3K | $5K | 20.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $1K | $3K | 25.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM ST, 24TH FLOOR CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $789 | $517 | $1K | 24.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM ST, 24TH FLOOR CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $518 | $347 | $865 | 25.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 NONE | Other fees; Claims processing; Float revenue; Direct payment from the plan Service code 12 | — | $133K |
| UMR INC EIN 39-1995276 NONE | Claims processing Service code 12 | — | $42K |
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 | 113 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNION SECURITY INSURANCE COMPANY | 113 | $24K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 113 | $27K |
| Short-term disability(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 113 | $37K |
| Long-term disability(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 113 | $29K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 104 | $227K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 109 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.