| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $25K | $2K | $27K | 1.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $24K | $2K | $26K | 1.22% |
| USI INSURANCE SERVICES LLC3 Filed as: WADE JOHNSON USI INSURANCE SERVICES | 100 SUMMIT LAKE DR., SUITE 400 VALHALLA, NY 10595 | DEAN HEALTH PLAN INC | $10K | — | $10K | 3.61% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62812 VIRGINIA BEACH, VA 234662889 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 554371180 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 580 N 4TH STREET STE 400 COLUMBUS, OH 432152153 | PRINCIPAL LIFE INSURANCE COMPANY | — | $844 | $844 | 0.52% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 203373 DALLAS, TX 753203373 | EYEMED VISION CARE | $1K | — | $1K | 6.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | P.O. BOX 203373 DALLAS, TX 753203373 | EYEMED VISION CARE | $588 | — | $588 | 3.16% |
| USI INSURANCE SERVICES LLC3 | 400 HWY 169 S SAINT LOUIS PARK, MN 55426 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $604 | $64 | $668 | 4.65% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE | STE 200 PEWAUKEE, WI 53072 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $251 | — | $251 | 1.75% |
| MIDWEST SELECT INSURANCE GROUP LLC3 | STE 200 PEWAUKEE, WI 53072 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $186 | — | $186 | 2.22% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSRUANCE SERVICES LLC | 400 HWY 169 S SAINT LOUIS PARK, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $167 | $4 | $171 | 2.04% |
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 | 473 | 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) | 473 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 331 | $2.4M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 342 | $162K |
| Vision | EYEMED VISION CARE | 263 | $19K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 342 | $162K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 38 | $23K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 38 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.