| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $45K | $50K | 1.47% |
| DSP INSURANCE SERVICES, INC.3 | 1900 E GOLF ROAD-STE 650 SCHAUMBURG, IL 60173 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $34K | $37K | 1.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $7K | $7K | 0.21% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET-FL 24 CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $5K | $5K | 0.13% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR-STE 400 BLOOMINGTON, MN 55437 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $2K | $14K | 4.70% |
| DS&P INSURANCE SERVICES, INC.3 | 1900 E GOLF ROAD - STE 650 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 3.56% |
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 | 341 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 342 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 683 | $3.4M |
| Dental(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 683 | $3.7M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 683 | $3.4M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 487 | $299K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 487 | $299K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 487 | $299K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 683 | $3.4M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 487 | $299K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 683 | — |
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.