| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 400 HIGHWAY 169 SOUTH, 8TH FLOOR SAINT LOUIS PARK, MN 55426 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $53K | $0 | $53K | 1.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203373 DALLAS, TX 75320 | HEALTHPARTNERS, INC. | $8K | $168 | $8K | 4.10% |
| USI INSURANCE SERVICES LLC3 | 8331 NORMAN CENTER DRIVE, SUITE 500 MINNEAPOLIS, MN 55437 | HARTFORD LIFE AND ACCIDENT | $17K | $0 | $17K | 16.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203373 DALLAS, TX 75320 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 10.00% |
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 | 392 | 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) | 392 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 610 | $3.2M |
| Dental | HEALTHPARTNERS, INC. | 623 | $202K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 387 | $16K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 392 | $104K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 392 | $104K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 610 | $3.2M |
| Other | HARTFORD LIFE AND ACCIDENT | 392 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 623 | — |
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.