| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203334 DALLAS, TX 75320 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $3K | $15K | 5.39% |
| USI INSURANCE SERVICES LLC3 | 100 NE 3RD AVENUE, SUITE 1050 FORT LAUDERDALE, FL 33301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $866 | $3K | 1.03% |
| EDIFY NORTH, LLC3 | PO BOX 2039 HOLLAND, MI 49422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $72 | $0 | $72 | 0.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203334 DALLAS, TX 75320 | UNUM INSURANCE COMPANY | $5K | $567 | $5K | 12.10% |
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 | 507 | 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) | 507 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF DELAWARE | 683 | $209K |
| Vision | VISION BENEFITS OF AMERICA | 298 | $32K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 507 | $275K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 507 | $275K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 507 | $275K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 507 | $320K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 683 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.