| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $45K | $3K | $48K | 3.70% |
| USI INSURANCE SERVICES LLC3 | 301 SOUTH COLLEGE STREET 19TH FLOOR CHARLOTTE, NC 28202 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $2K | $0 | $2K | 2.12% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 7.59% |
| USI INSURANCE SERVICES LLC3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $558 | $558 | 0.95% |
| USI INSURANCE SERVICES LLC3 | 400 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $664 | $116 | $780 | 16.49% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 285 | $1.3M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 331 | $146K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 331 | $146K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 278 | $64K |
| Prescription drug | MEDICA INSURANCE COMPANY | 285 | $1.3M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 278 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 331 | — |
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.