| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 222 S RIVERSIDE PLZ STE 630 CHICAGO, IL 60606 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 5.04% |
| KEY BENEFIT ADMINISTRATORS, INC5 Filed as: KEY BENEFIT ADMINISTRATORS, INC. | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | UNITED HEALTHCARE | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC EIN 35-1450364 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $86K |
| USI INSURANCE SERVICES, LLC EIN 31-0507943 NONE | Insurance agents and brokers Service code 22 | 4605 COLUMBUS ST VIRGINIA BEACH, VA 23462 | $41K |
| LUTHERN NETWORK EIN 35-0234810 NONE | Contract Administrator Service code 13 | P.O. BOX 11588 FORT WAYNE, IN 46859 | $14K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-0248379 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $12K |
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $4K |
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 | 246 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GERBER LIFE INSURANCE COMPANY | 246 | $714K |
| Life insurance | STANDARD INSURANCE COMPANY | 116 | $66K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 249 | $82K |
| Other | UNITED HEALTHCARE | 246 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.