| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $23K | $0 | $23K | 8.38% |
| USI INSURANCE SERVICES LLC3 | 2375 EAST CAMELBACK ROAD, SUITE 250 PHOENIX, AZ 85016 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $18K | $0 | $18K | 6.62% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $10K | $10K | 3.50% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 13.52% |
| DAVID J. KLEINSMITH4 | PO BOX 610 MAPLE HILL, KS 66507 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $507 | $0 | $507 | 3.89% |
| K C A MARKETING, INC.4 | PO BOX 1702 MAPLE GROVE, MN 55311 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $87 | $0 | $87 | 0.67% |
| VALERIE HANSON4 | 1732 WHITESTONE CIRCLE SOUTH FARGO, ND 58103 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $59 | $0 | $59 | 0.45% |
| DIANNE M. CHURIK4 | 10940 CROOKED LANE BOULEVARD NORTH APARTMENT 424 MINNEAPOLIS, MN 55433 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $38 | $0 | $38 | 0.29% |
| ALAN W. JUDD4 | 3532 LONG LAKE ROAD EAST SAINT PAUL, MN 55115 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $29 | $0 | $29 | 0.22% |
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 | 383 | 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) | 383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | 358 | $12K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 383 | $275K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 383 | $275K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 383 | $275K |
| Other(2 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 383 | $288K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 383 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.