| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $14K | $4K | $18K | 2.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN | STATES LTD PO BOX 2158 RIVERSIDE, CA 92516 | MEDICA INSURANCE COMPANY | $14K | — | $14K | 1.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 11516 MIRACLE HILLS DR OMAHA, NE 68154 | DELTA DENTAL OF MINNESOTA | $4K | — | $4K | 5.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MINNESOTA | $3K | — | $3K | 4.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 1133 W 57TH ST SIOUX FALLS, SD 57108 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 7.76% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 7.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPNANY OF NORTH AMERICA | $907 | — | $907 | 5.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 1300 W 57TH ST SIOUX FALLS, SD 57108 | LIFE INSURANCE COMPNANY OF NORTH AMERICA | $890 | — | $890 | 4.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 1300 W 57TH ST SIOUX FALLS, SD 57108 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 7.81% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 7.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 11516 MIRACLE HILLS DR OMAHA, NE 68154 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $641 | — | $641 | 6.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | 8331 NORMAN CENTER DRIVE, STE 500 MINNEAPOLIS, MN 55413 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $418 | — | $418 | 3.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 1300 W 57TH ST SIOUX FALLS, SD 57108 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $202 | — | $202 | 7.79% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $188 | — | $188 | 7.25% |
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 | 155 | 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) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 142 | $895K |
| Dental | DELTA DENTAL OF MINNESOTA | 170 | $78K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 119 | $11K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 220 | $20K |
| Short-term disability | LIFE INSURANCE COMPNANY OF NORTH AMERICA | 56 | $18K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 155 | $20K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 220 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.