| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3716 NORFOLK, VA 23514 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $27 | $7K | 11.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3716 NORFOLK, VA 23514 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 2.29% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $158 | $1K | 1.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 222 S RIVERSIDE PLAZA, SUITE 630 CHICAGO, IL 60606 | GUARDIAN | $722 | — | $722 | 3.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS CORP OF IL | 234 SPRING LAKE DRIVE ITASCA, IL 60143 | LINCOLN FINANCIAL GROUP | $2K | — | $2K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | PO BOX 62889 PO BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED | $919 | — | $919 | 9.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS CORP OF IL | 234 SPRING LAKE DRIVE ITASCA, IL 60143 | LINCOLN FINANCIAL GROUP | $513 | — | $513 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS EIN 36-3086057 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $86K |
| ALLIED BENEFIT SYSTEMS, INC. EIN 36-3086057 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $75K |
| USI MIDWEST BROKER | Insurance agents and brokers Service code 22 | 222 S RIVERSIDE PLAZA, SUITE 630 CHICAGO, IL 60606 | $22K |
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 | 331 | 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) | 331 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 368 | $82K |
| Vision | EYEMED | 212 | $9K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 368 | $68K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 368 | $75K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 368 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 368 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.