| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 203510 DALLAS, TX 75230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $35K | — | $35K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $693 | — | $693 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $557K |
| USI SERVICES NONE | Insurance agents and brokers Service code 22 | PO BOX 203510 DALLAS, TX 75320 | $58K |
| GASTON FAMILY HEALTH SERVICES INC. EIN 58-1958398 NONE | Other services Service code 49 | — | $58K |
| CORPORATE BENEFIT SERVICES INC. EIN 56-1167792 NONE | Insurance agents and brokers; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $30K |
| WEST HEALTH ADVOCATE SOLUTIONS, INC EIN 23-3080019 NONE | Insurance agents and brokers Service code 22 | — | $22K |
| TEAM PHARMACY CONSULTING EIN 46-5635028 NONE | Other services Service code 49 | — | $21K |
| GREERWALKER LLP EIN 56-1434747 NONE | Accounting (including auditing) Service code 10 | — | $16K |
| MCGRIFF EMPLOYEE BENEFIT SOLUTION NONE | Actuarial Service code 11 | 7701 AIRPORT CENTER DRIVE GREENSBORO, NC 27409 | $6K |
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 | 908 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 915 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 908 | $348K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 908 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 908 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.