| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $6K | $9K | 9.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-MIDWEST | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $7K | $21K | 31.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- MIDWEST | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $4K | $7K | 13.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- MIDWEST | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $6K | $14K | 35.12% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 312 ELM STREET CINCINNATI, OH 45202 | MEDICAL MUTUAL | $961 | — | $961 | 3.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- MIDWEST | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $638 | $3K | $4K | 61.05% |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 325 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 289 | $96K |
| Vision | MEDICAL MUTUAL | 205 | $24K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 484 | $46K |
| Short-term disability | MEDMUTUAL LIFE INSURANCE COMPANY | 177 | $57K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $66K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 274 | $170K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 484 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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.