| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA HEALTH, INC. | $39K | — | $39K | 2.33% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA HEALTH, INC. | $22K | — | $22K | 1.33% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE HOLDINGS INC | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | AETNA HEALTH, INC. | $11K | — | $11K | 0.67% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO | $6K | $7K | $13K | 2.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 S FL 12 SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO | $10K | — | $10K | 2.05% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE HOLDINGS INC | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | AETNA LIFE INSURANCE CO | $3K | — | $3K | 0.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $57 | $9K | 6.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.86% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS (24) | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $270 | $11K | 10.60% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | $0 | $1K | 3.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $562 | $562 | 1.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURNACE COMPANY | $2K | — | $2K | 5.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURNACE COMPANY | $964 | — | $964 | 3.50% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERV. USA INC | 21250 HAWTHORNE BLVD., SUITE 600 SUITE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $2 | $0 | $2 | 5.13% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERV. USA INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $0 | $1 | $1 | 2.56% |
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 | 317 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 67 | $498K |
| Dental(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 317 | $192K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURNACE COMPANY | 191 | $44K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 317 | $146K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 317 | $264K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.