| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, LLC3 Filed as: ALLIED BENEFIT SYSTEMS, INC. | 200 W. ADAMS STREET. SUITE 500 CHICAGO, IL 60606 | STANDARD LIFE INSURANCE COMPANY | $131K | — | $131K | 25.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 307 SOUTH MAIN STREET SUITE 200 ELKHART, IN 46516 | STANDARD LIFE INSURANCE COMPANY | $85K | — | $85K | 16.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC | 307 SOUTH MAIN STREET SUITE 200 ELKHART, IN 46516 | STANDARD LIFE INSURANCE COMPANY | $20K | — | $20K | 3.88% |
| SAGAMORE HEALTH NETWORK3 | 11595 NORTH MERIDIAN STREET SUTIE 600 CARMEL, IN 46032 | STANDARD LIFE INSURANCE COMPANY | $20K | — | $20K | 3.78% |
| AMERICAN HEALTH HOLDING3 | 7400 W. CAMPUS RD. NEW ALBANY, OH 43054 | STANDARD LIFE INSURANCE COMPANY | $11K | — | $11K | 2.03% |
| MERITAIN HEALTH3 Filed as: AETNA LIFE INSURANCE COMPANY | 7400 W. CAMPUS RD. NEW ALBANY, OH 43054 | STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 1.48% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 307 S. MAIN STREET #200 ELKHART, IN 46516 | HARTFORD LIFE AND ACCIDENT | $50K | — | $50K | 15.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 307 S. MAIN STREET #200 ELKHART, IN 46516 | VISION SERVICE PLAN | $94K | $12K | $106K | 130.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | PO BOX 3727 NORFOLK, VA 23414 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $30K | — | $30K | 59.27% |
| DAWN WISE4 | DBA JJ AND DR ENTERPRISES LLC 72057 COUNTRY ROAD 17 NEW PARIS, IN 46553 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 8.97% |
| KELLY HALL WIENING4 Filed as: KELLY HALL WEINING | 2835 FIR LANE SOUTH BEND, IN 46615 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 8.59% |
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 | 567 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 567 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 104 | $50K |
| Vision | VISION SERVICE PLAN | 548 | $81K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 577 | $319K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 577 | $319K |
| Stop-loss / reinsurancereinsurance | STANDARD LIFE INSURANCE COMPANY | 372 | $520K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 577 | $332K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 577 | — |
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.
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.