| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | MOUNTAIN CENTRAL PO BOX 62187 VIRG, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $9K | $14K | 12.43% |
| USI INSURANCE SERVICES LLC3 | MOUNTAIN CENTRAL PO BOX 62187 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $5K | $10K | 15.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | SUPERIOR VISION PLAN OF WISCONSIN INC | $6K | — | $6K | 10.00% |
| USI INSURANCE SERVICES LLC3 | MOUNTAIN CENTRAL PO BOX 62187 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $5K | $13K | 23.63% |
| USI INSURANCE SERVICES LLC3 | MOUNTAIN CENTRAL PO BOX 62187 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $871 | $3K | 28.25% |
| USI INSURANCE SERVICES LLC3 | MOUNTAIN CENTRAL PO BOX 62187 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $825 | $2K | 23.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-MTN CENT | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $839 | $737 | $2K | 18.78% |
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 | 373 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION PLAN OF WISCONSIN INC | 331 | $57K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 503 | $65K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $116K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 125 | $64K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 503 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 503 | — |
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.