| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INC. | 3910 FAIRVIEW PARK DRIVE SUITE 400 FALLS CHURCH, VA 22042 | BLUERE OF TENNESSEE | $10K | — | $10K | 4.51% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 2.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $101 | $2K | 1.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE GROUP SERVICES INC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $112 | $3K | 4.56% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOICATES INSURANCE GROUP | 1 KELLY WAY SPARKS, MD 21152 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 4.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $111 | $4K | 7.69% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 7.52% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $92 | $2K | 3.40% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOICATES INSURANCE GROUP | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.10% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $659 | — | $659 | 6.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $596 | $21 | $617 | 6.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS TN - KELLY - USI EIN 62-0427913 NONE | Insurance services; Insurance agents and brokers; Contract Administrator; Claims processing Service code 12 | — | $188K |
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 | 355 | 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) | 356 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 211 | $106K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 355 | $10K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 355 | $51K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 355 | $58K |
| Other(3 contracts, 2 carriers) | BLUERE OF TENNESSEE | 355 | $284K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 355 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.