| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | UNIMERICA LIFE INSURANCE COMPANY | $22K | $0 | $22K | 3.66% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERIVCE OF NORT | PO BOX 3716 NORFOLK, VA 235143716 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.75% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES OF NORT | PO BOX 3716 NORFOLK, VA 235143716 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $212 | $0 | $212 | 0.75% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES CORP | 200 SUMMIT LAKE DR STE 350 VALHALLA, NY 10595 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
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 | 1,328 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIMERICA LIFE INSURANCE COMPANY | 1,318 | $609K |
| Vision | VISION SERVICE PLAN | 1,345 | $252K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,514 | $167K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,514 | $167K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,514 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.