| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $40K | $7K | $46K | 2.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $27K | $4K | $31K | 15.97% |
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | 1331 HEATHER COURT CHANHASSEN, MN 55317 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 0.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HEALTHPARTNERS, INC. | $5K | $27 | $5K | 3.94% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | UNITEDHEALTHCARE INSURANCE COMPANY | $521 | $0 | $521 | 10.01% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $199 | $199 | 3.82% |
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 | 384 | 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) | 384 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 232 | $2.0M |
| Dental | HEALTHPARTNERS, INC. | 249 | $127K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 150 | $5K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 384 | $195K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 384 | $195K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 384 | $195K |
| Prescription drug | MEDICA INSURANCE COMPANY | 232 | $2.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 384 | $195K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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.