| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $846 | $5K | 4.49% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $1K | $5K | 4.96% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $249 | $3K | 14.03% |
| USI INSURANCE SERVICES LLC | PO BOX 203373 DALLAS, TX 75320 | EYEMED VISION CARE C/O FIDELITY SECURITY LIFE INSURANCE COMPANY | $683 | — | $683 | 6.68% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203373 DALLAS, TX 75320 | EYEMED VISION CARE C/O FIDELITY SECURITY LIFE INSURANCE COMPANY | $344 | — | $344 | 3.36% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $76 | $1K | 16.08% |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 142 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 404 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE C/O FIDELITY SECURITY LIFE INSURANCE COMPANY | 144 | $10K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 412 | $104K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $109K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 94 | $25K |
| Stop-loss / reinsurancereinsurance | MEDICA INSURANCE COMPANY | 733 | $490K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 271 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 733 | — |
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."
No prospect flags tripped on this filing.