| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED BENEFITS AND R3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $0 | $21K | 4.59% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $2K | $16K | 3.55% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $3K | $14K | 3.12% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 100 BLOOMINGTON, MN 55437 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $6K | $0 | $6K | 10.77% |
| SHERRY SWEDENBORG4 Filed as: SHERRY L. SWEDENBORG | 4500 SOUTH MONACO STREET SUITE 2021 DENVER, CO 80237 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 7.45% |
| JOSEPH HUTH4 | 3863 CRESTWOOD PLACE WHITE BEAR LAKE, MN 51100 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 6.80% |
| USI INSURANCE SERVICES LLC4 | 6800 FRANCE AVENUE SOUTH MINNEAPOLIS, MN 55435 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 4.59% |
| BLUMCIA BUSINESS SOLUTIONS4 | 3440 YOUNGFIELD STREET, PMB 271 WHEAT RIDGE, CO 80033 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $55 | $0 | $55 | 0.17% |
| MARY L. ROMERO4 | 20439 AGER BESWICK ROAD MONTAGUE, CA 96064 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $29 | $0 | $29 | 0.09% |
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 | 908 | 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) | 908 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 814 | $53K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 908 | $453K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 908 | $453K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 908 | $485K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 908 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.