| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | UNITED HEALTHCARE INSURANCE COMPANY | $45K | $2K | $47K | 4.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3100 MONTICELLO, SUITE 300 DALLAS, TX 75205 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $6K | $13K | 10.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 4.14% |
| ERIK G LILJENWALL3 Filed as: ERIK G. LILJENWALL | 4907 FAST FOX AUSTIN, TX 78746 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $302 | — | $302 | 0.24% |
| JOHN J MCGURRAN3 Filed as: JOHN J. MCGURRAN | 5235 RICHARD AVENUE DALLAS, TX 75206 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $62 | — | $62 | 0.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 7600B NORTH CAPITAL OF TX HIGHWAY SUITE 200 AUSTIN, TX 78731 | EYEMED VISION CARE | $1K | — | $1K | 9.98% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 270 | $991K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 96 | $124K |
| Vision | EYEMED VISION CARE | 254 | $12K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $61K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $61K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $61K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 270 | $991K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.