| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC | P.O. BOX 61187 VIRGINIA BEACH, VA 234661187 | BLUECROSS BLUESHIELD OF TEXAS | $168K | $8K | $177K | 1.16% |
| USI INSURANCE SERVICES LLC3 | SOUTHWEST - NEW ORLEANS PO BOX 61187 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $82K | — | $82K | 10.00% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $163 | $163 | 0.02% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN L. WORTHAM & SON, L.P. | PO BOX 1388 HOUSTON, TX 775211388 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $47K | — | $47K | 7.40% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 9811 KATY FREEWAY HOUSTON, TX 770241273 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $17K | — | $17K | 2.60% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | PO BOX 61187 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $18K | — | $18K | 3.00% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 61187 VIRGINIA BEACH, VA 234661187 | VISION SERVICE PLAN | $12K | — | $12K | 10.16% |
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 | 817 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 842 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TEXAS | 2,184 | $15.8M |
| Dental(2 contracts, 2 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 832 | $1.2M |
| Vision | VISION SERVICE PLAN | 852 | $121K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,144 | $819K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,144 | $819K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,144 | $1.5M |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 2,184 | $15.2M |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF TEXAS | 2,184 | $15.2M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,144 | $819K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,184 | — |
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.