| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $33K | $0 | $33K | 15.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $11K | $11K | 4.81% |
| STEVE BAKER3 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $904 | $0 | $904 | 8.61% |
| DAVID J. KLEINSMITH3 | PO BOX 610 MAPLE HIL, KS 66507 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $654 | $0 | $654 | 6.23% |
| KCA MARKETING INC DBA LEGAL BENEFIT3 Filed as: KCA MARKETING, INC. | PO BOX 1702 MAPLE GROVE, MN 55311 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $87 | $0 | $87 | 0.83% |
| VALERIE HANSON3 | 1732 WHITESTONE CIRCLE SOUTH FARGO, ND 58103 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $59 | $0 | $59 | 0.56% |
| DIANNE M. CHURIK3 | 10940 CROOKED LAKE BOULEVARD NORTH APARTMENT 424 MINNEAPOLIS, MN 55433 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $38 | $0 | $38 | 0.36% |
| ALAN W. JUDD3 | 3532 LONG LAKE ROAD EAST SAINT PAUL, MN 55115 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $28 | $0 | $28 | 0.27% |
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 | 332 | 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) | 332 | 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 | 302 | $12K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 332 | $220K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 332 | $220K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 332 | $220K |
| Other(2 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 332 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.