| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS AND BLUE SHIELD OF WISCONSIN | $29K | $1K | $31K | 9.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 14.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $970 | $970 | 5.00% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.11% |
| USI INSURANCE SERVICES LLC3 | STE 400 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $852 | $852 | 5.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 10.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $535 | $535 | 5.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $1K | — | $1K | 10.14% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $940 | — | $940 | 10.06% |
| USI INSURANCE SERVICES LLC3 | STE 400 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $470 | $470 | 5.03% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 129 | $623K |
| Dental | BLUE CROSS AND BLUE SHIELD OF WISCONSIN | 129 | $310K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 133 | $10K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $26K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 47 | $11K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 38 | $19K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.