| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | $114K | $0 | $114K | 3.13% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $3K | $9K | 3.71% |
| ASSOCIATED BENEFITS3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $0 | $14K | 10.01% |
| USI INSURANCE SERVICES LLC3 | 7555 MARKET PLACE DRIVE EDEN PRAIRIE, MN 55344 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $161 | $2K | $2K | 1.68% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | $0 | $4K | 17.58% |
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 | 197 | 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) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | 550 | $3.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 886 | $244K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 549 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 197 | $137K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 197 | $137K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 197 | $137K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | 550 | $3.6M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 197 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 886 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.