| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 200 N ADAMS STREET GREEN BAY, WI 54301 | HEALTHPARTNERS INSURANCE COMPANY-NE WI | $41K | $28 | $41K | 2.06% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $11K | $3K | $15K | 9.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 9.98% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE | P.O. BOX 23921 NEW YORK, NY 10087 | LEGALPLANS, USA | — | $62 | $62 | 1.00% |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHPARTNERS INSURANCE COMPANY-NE WI | 253 | $2.0M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 180 | $12K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 184 | $154K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 184 | $154K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 184 | $154K |
| Prescription drug | HEALTHPARTNERS INSURANCE COMPANY-NE WI | 253 | $2.0M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 184 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.