| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $2K | $10K | 8.86% |
| FIRST MERCHANTS INSURANCE SERVICES3 | 302 E JACKSON ST MUNCIE, IN 47305 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $681 | — | $681 | 0.62% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 11.99% |
| FIRST MERCHANTS INSURANCE SERVICES3 | 302 E JACKSON ST MUNCIE, IN 47305 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $298 | — | $298 | 0.78% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRIGINA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY (G1400) | $2K | — | $2K | 6.72% |
| FIRST MERCHANTS INSURANCE SERVICES3 | 302 E JACKSON STREET MUNCIE, IN 47305 | ANTHEM LIFE INSURANCE COMPANY (G1400) | $570 | — | $570 | 2.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | — | $1K | 4.32% |
| FIRST MERCHANTS INSURANCE3 | PO BOX 620309 FORT RUCKER, AL 36362 | VISION SERVICE PLAN | $193 | — | $193 | 0.82% |
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 | 174 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 178 | $109K |
| Vision | VISION SERVICE PLAN | 170 | $24K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY (G1400) | 166 | $24K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 180 | $38K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC (G2001) | 174 | $277K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.