| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 1 INTERNATIONAL PLZ STE 400 PHILADELPHIA, PA 191131535 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $27 | $2K | 2.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | METROPOLITAN LIFE INSURANCE COMPANY | — | $891 | $891 | 1.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 4605 COLUMBUS ST VIRGINIA BEACH, VA 234626791 | METROPOLITAN LIFE INSURANCE COMPANY | — | $118 | $118 | 0.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 308 N 21ST ST ST. LOUIS, MO 631031642 | METROPOLITAN LIFE INSURANCE COMPANY | — | $27 | $27 | 0.03% |
| VARIOUS-DETAILS ON FILE3 | VARIOUS VARIOUS, IL 99999 | AFLAC | $2K | $96 | $2K | 13.17% |
| USI INSURANCE SERVICES LLC3 | 308 N 21ST ST ST. LOUIS, MO 63103 | VISION BENEFITS OF AMERICA | $439 | $3K | $4K | 40.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 115 W WAUSAU AVE WAUSAU, WI 54401 | $53K |
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 | 116 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 102 | $78K |
| Vision | VISION BENEFITS OF AMERICA | 68 | $9K |
| Short-term disability | AFLAC | 18 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 102 | — |
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.