| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 234662817 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $65 | $6K | 9.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 234662817 | METROPOLITAN LIFE INSURANCE COMPANY | — | $757 | $757 | 1.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 234662817 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2 | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 7.66% |
| NORTHWEST WORKSITE MARKETING CORP3 | 1910 INDIAN WOOD CT MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $596 | $390 | $986 | 2.48% |
| NORTHWEST ENROLLX LLC3 | 7656 TWP RD. 94 FINDLAY, OH 45840 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $588 | $381 | $969 | 2.44% |
| KEITH A PFAUTZ3 Filed as: KEITH A. PFAUTZ | 1208 N. MADISON AVE. NEWTON, KS 67114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $369 | $502 | $871 | 2.19% |
| VARIOUS3 | PO BOX 1365 COLUMBIA, SC 292021365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $359 | $397 | $756 | 1.90% |
| USI INSURANCE SERVICES LLC3 | 5100 POPLAR AVE. MEMPHIS, TN 38137 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $196 | $308 | $504 | 1.27% |
| USI INSURANCE SERVICES LLC3 | 245 N WACO, SUITE 412 WICHITA, KS 67202 | VCP SERVICES, INC. | $2K | $0 | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, LLC EIN 36-3086057 NONE | Claims processing Service code 12 | — | $58K |
| USI INSURANCE SERVICES EIN 13-3771734 NONE | Insurance agents and brokers Service code 22 | — | $21K |
| WPPA NONE | Other services Service code 49 | 1102 S. HILLSIDE WICHITA, KS 67211 | $14K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 NONE | Other services Service code 49 | — | $5K |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 361 | $66K |
| Vision | VCP SERVICES, INC. | 112 | $17K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 141 | $45K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 132 | $60K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 132 | $60K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | ZURICH AMERICAN LIFE INSURANCE COMPANY | 110 | $350K |
| Other | ADVANCE INSURANCE COMPANY OF KANSAS | 141 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.