| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | COMMUNITY INSURANCE COMPANY | — | $851 | $851 | 0.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | COMMUNITY INSURANCE COMPANY | $5K | $4K | $9K | 4.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | DENTAL CARE PLUS, INC. | $8K | — | $8K | 7.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $49 | $6K | 10.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 4.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $47 | $6K | 10.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 4.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 8.51% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $27 | $6K | 15.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | 312 ELM STREET, 24TH FL CINCINNATI, OH 45202 | DENTAL CARE PLUS, INC. | $2K | — | $2K | 7.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Float revenue; Other services; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $316K |
| USI MIDWEST, LLC EIN 31-0507943 NONE | Other commissions; Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | — | $49K |
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 | 622 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 622 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | COMMUNITY INSURANCE COMPANY | 413 | $438K |
| Dental(2 contracts) | DENTAL CARE PLUS, INC. | 317 | $150K |
| Vision(2 contracts) | COMMUNITY INSURANCE COMPANY | 413 | $438K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 622 | $100K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 302 | $48K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 622 | $58K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 357 | $249K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 622 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 622 | — |
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.