| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 2711 NORTH HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | BLUE CROSS BLUE SHIELD OF TEXAS | $98K | $999 | $99K | 4.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $14K | 11.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 101 SUMMIT AVENUE, SUITE 600 FORT WORTH, TX 73490 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $726 | $7K | 8.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 2711 NORTH HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 2.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 11.67% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 290 | $2.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 117 | $121K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 90 | $18K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $87K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $87K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF TEXAS | 290 | $2.3M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.