| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $62K | $57 | $62K | 9.90% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $26K | $26K | 4.21% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $22K | $22K | 3.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 1.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $57 | $25K | 21.24% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 3.71% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET FL 24 CINCINNATI, OH 45202 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 2.26% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $10 | $10 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $57 | $12K | 21.08% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 3.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 2.20% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5 | $5 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KENTUCKY INC EIN 31-1237516 ADMIN | Float revenue; Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.1M |
| USI INS SERVICES LLC | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $93K |
| INGENIORX, INC. EIN 82-3062245 ADMIN | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | -$105K |
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 | 455 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 455 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,146 | $627K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,146 | $627K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,146 | $627K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,146 | $627K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,146 | $627K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 994 | $689K |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,146 | $801K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,146 | — |
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.