| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC (MIDWEST | PO BOX 62889 VIRGINIA BEACH, VA 23466 | COVENTRY HEALTH AND LIFE | $17K | — | $17K | 1.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. (ST. LOUIS) | 308 N 21ST STREET ST. LOUIS, MO 63103 | COVENTRY HEALTH AND LIFE | $10K | — | $10K | 1.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | PO BOX 3176 NORFOLK, VA 235143716 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $651 | $651 | 5.98% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $363 | — | $363 | 3.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $182 | — | $182 | 1.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | PO BOX 3176 NORFOLK, VA 235143716 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $441 | $441 | 6.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $253 | — | $253 | 3.47% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $111 | — | $111 | 1.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | PO BOX 3176 NORFOLK, VA 235143716 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $425 | $425 | 5.87% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $242 | — | $242 | 3.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $120 | — | $120 | 1.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MO EIN 43-0908349 NONE | Contract Administrator; Claims processing Service code 12 | — | $10K |
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 | 201 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COVENTRY HEALTH AND LIFE | 229 | $904K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 184 | $7K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 184 | $7K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 48 | $7K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 184 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.