| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HIGHWAY 169 SOUTH ST LOUIS PARK, MN 55426 | HARTFORD LIFE AND ACCIDENT | $17K | $0 | $17K | 9.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 1.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8331 NORMAN CENTER DRIVE, SUITE 500 MINNEAPOLIS, MN 55437 | HARTFORD LIFE AND ACCIDENT | $746 | $0 | $746 | 0.44% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | TEN SOUTH WACKER DRIVE, 17TH FLOOR CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $75 | $75 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 8000 NORMAN CENTER DRIVE SUITE 400 BLOOMINGTON, MN 55437 | VISION SERVICE PLAN EASTERN | $2K | $0 | $2K | 3.18% |
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 | 740 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 740 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN EASTERN | 469 | $68K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 740 | $170K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 740 | $170K |
| Other | HARTFORD LIFE AND ACCIDENT | 740 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 740 | — |
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.