| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLE, NY 10595 | STANDARD LIFE INSURANCE COMPANY | $80K | — | $80K | 16.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC | 307 SOUTH MAIN STREET SUITE 200 ELKHART, IN 46516 | STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| SAGAMORE HEALTH NETWORK3 | 11595 NORTH MERIDIAN STREET SUTIE 600 CARMEL, IN 46032 | STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| AMERICAN HEALTH HOLDING3 | 7400 W. CAMPUS RD. NEW ALBANY, OH 43054 | STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| MERITAIN HEALTH3 Filed as: AETNA LIFE INSURANCE COMPANY | 7400 W. CAMPUS RD. NEW ALBANY, OH 43054 | STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2 | $8K | $8K | 6.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 6.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | 307 S. MAIN ST. #200 ELKHART, IN 46516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $7K | $7K | 6.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 6.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | 307 S. MAIN ST.#200 ELKHART, IN 46516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 3.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 3176 NORFOLK, VA 23514 | THELINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 6.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THELINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 6.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | 307 S. MAIN ST. #200 ELKHART, IN 46516 | THELINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3727 NORFOLK, VA 23414 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10K | — | $10K | 18.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST | 307 S. MAIN STREET, SUITE 200 ELKHART, IN 46514 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $605 | — | $605 | 1.13% |
| KELLY HALL WIENING4 Filed as: KELLY HALL WEINING | 2835 FIR LANE SOUTH BEND, IN 46615 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 13.46% |
| DAWN WISE4 | DBA JJ AND DR ENTERPRISES LLC 72057 COUNTRY ROAD 17 NEW PARIS, IN 46553 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $979 | — | $979 | 12.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, INC. EIN 36-3086057 TPA | Claims processing Service code 12 | — | $124K |
| USI MIDWEST, INC. BROKER | Claims processing Service code 12 | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLE, NY 10595 | $19K |
| SEGAMORE HEALTH NETWORK PPO | Claims processing Service code 12 | 11595 N. MERIDIAN ST. #600 CARMEL, IN 46032 | $18K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 OTHER SERVICE PROVIDER | Claims processing Service code 12 | — | $14K |
| SELECT HEALTH NETWORK PPO | Claims processing Service code 12 | 401 E. COLFAX SUITE 100 SOUTH BEND, IN 46617 | $14K |
| AMERICAN HEALTH HOLDING OTHER SERVICE PROVIDER | Claims processing Service code 12 | 7400 WEST CAMPUS ROAD F-510 NEW ALBANY, OH 43054 | $10K |
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 | 504 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 130 | $53K |
| Vision | VISION SERVICE PLAN | 504 | $89K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 532 | $176K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 494 | $103K |
| Stop-loss / reinsurancereinsurance | STANDARD LIFE INSURANCE COMPANY | 519 | $490K |
| Other(3 contracts, 3 carriers) | THELINCOLN NATIONAL LIFE INSURANCE COMPANY | 532 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 532 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.