| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | $18K | — | $18K | 1.13% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | $17K | — | $17K | 1.09% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | DELTA DENTAL OF MISSOURI | $2K | — | $2K | 2.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MISSOURI | $1K | — | $1K | 1.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | HARTFORD LIFE AND ACCIDENT | $8K | $268 | $8K | 18.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $313 | $4K | 21.89% |
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 | 305 | 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) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | 260 | $1.6M |
| Dental | DELTA DENTAL OF MISSOURI | 303 | $76K |
| Vision | DELTA DENTAL OF MISSOURI | 303 | $76K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 305 | $42K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 160 | $17K |
| Prescription drug | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | 260 | $1.6M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 305 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.