| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST | 222 SOUTH RIVERSIDE PLZ, SUITE 630 CHICAGO, IL 60606 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $10K | $10K | 2.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 1 HILLCREST DRIVE EAST CHARLESTON, WV 25311 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 0.87% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 3716 NORFOLK, VA 235143716 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM STREET FL 24 CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 1.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM STREET FL 24 CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $721 | — | $721 | 1.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Insurance brokerage commissions and fees; Other services Service code 49 | — | $487K |
| USI MIDWEST INC BROKER | Other commissions Service code 55 | 312 ELM STREET FL 24 CINCINNATI, OH 45202 | $0 |
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 | 856 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 865 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,558 | $392K |
| Vision | VISION SERVICE PLAN | 811 | $68K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 7,023 | $470K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 7,023 | $470K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 7,023 | $470K |
| Stop-loss / reinsurancereinsurance(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,454 | $405K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 7,023 | $470K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,023 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.