| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $16K | $36K | 15.19% |
| USI INSURANCE SERVICES LLC3 | 400 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 5.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203312 DALLAS, TX 75320 | VISION SERVICE PLAN | $3K | $0 | $3K | 9.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $985 | $0 | $985 | — |
| MARC A GROVE3 Filed as: MARC A. GROVE | 2590 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $454 | $143 | $597 | — |
| MJ INSURANCE3 Filed as: DANIEL FROST AND VARIOUS AGENTS | 241 POYGAN ROAD OMRO, WI 54963 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $358 | $37 | $395 | — |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $234 | $0 | $234 | — |
| ROSE MARY GOODMAN3 | 5200 HOLLY LANE NORTH, SUITE 4 PLYMOUTH, MN 55446 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $90 | $0 | $90 | — |
| TR INSURANCE ADVISORS INC3 Filed as: TR INSURANCE ADVISORS, INC. | 1009 EIGHTH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $77 | $4 | $81 | — |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $68 | $6 | $74 | — |
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 | 414 | 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) | 414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 262 | $27K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 414 | $240K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 414 | $240K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 414 | $240K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 414 | $240K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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.