| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $45K | $917 | $46K | 2.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | — | $917 | $917 | 0.05% |
| USI INSURANCE SERVICES LLC3 Filed as: WADE JOHNSON USI INSURANCE SERVICES | 100 SUMMIT LAKE DR., SUITE 400 VALHALLA, NY 10595 | DEAN HEALTH PLAN INC | $9K | — | $9K | 3.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 234662817 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 6.77% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 203373 DALLAS, TX 753203373 | EYEMED VISION CARE | $883 | — | $883 | 5.09% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $865 | — | $865 | 4.99% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 55437 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $916 | $127 | $1K | 8.27% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE | STE 2E EAU CLAIRE, WI 54701 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $184 | — | $184 | 1.46% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSRUANCE SERVICES LLC | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $152 | $8 | $160 | 2.66% |
| MIDWEST SELECT INSURANCE GROUP LLC3 | STE 2E EAU CLAIRE, WI 54701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14 | — | $14 | 0.23% |
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 | 368 | 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) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 291 | $2.2M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 341 | $156K |
| Vision | EYEMED VISION CARE | 231 | $17K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 341 | $156K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 36 | $19K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 36 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 341 | — |
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.