| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST | 840 GESSNER ROAD STE 600 HOUSTON, TX 770244145 | MUTUAL OF OMAHA INSURANCE COMPANY | $8K | $1K | $9K | 7.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 840 GESSNER ROAD STE 600 HOUSTON, TX 770244145 | MUTUAL OF OMAHA INSURANCE COMPANY | $7K | $1K | $8K | 6.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 840 GESSNER ROAD STE 600 HOUSTON, TX 770244145 | MUTUAL OF OMAHA INSURANCE COMPANY | $7K | $1K | $8K | 6.44% |
| UNITED OF OMAHA LIFE INSURANCE CO Filed as: MUTUAL OF OMAHA LIFE INSURANCE COMP | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $2K | $2K | 1.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 840 GESSNER ROAD STE 600 HOUSTON, TX 770244145 | MUTUAL OF OMAHA INSURANCE COMPANY | $627 | $196 | $823 | 0.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 | Other services; Claims processing Service code 12 | 9900 BREN ROAD EAST MINNETONKA, MN 55343 | $112K |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MUTUAL OF OMAHA INSURANCE COMPANY | 153 | $117K |
| Dental | MUTUAL OF OMAHA INSURANCE COMPANY | 153 | $117K |
| Vision | MUTUAL OF OMAHA INSURANCE COMPANY | 153 | $117K |
| Life insurance | MUTUAL OF OMAHA INSURANCE COMPANY | 153 | $117K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 153 | $117K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 153 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.