| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 2711 N HASKEL AVE, STE 2000 DALLAS, TX 752042914 | BLUE CROSS BLUE SHIELD | $65K | — | $65K | 7.52% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD | — | $1K | $1K | 0.12% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 200 SUMMIT LAKE DRIVE STE 350 VALHALLA, NY 10595 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 9.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 200 SUMMIT LAKE DRIVE STE 350 VALHALLA, NY 10595 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $214 | — | $214 | 0.90% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 300 ATLANTA, GA 30339 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $80 | $64 | $144 | 0.61% |
| ERIK G LILJENWALL3 Filed as: ERIK G. LILJENWALL | 4130 SPICEWOOD SPRINGS RD, STE 200 AUSTIN, TX 78759 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| OPES ONE ADVISORS LLC3 | 15303 N DALLAS PARKWAY ADDISON, TX 75001 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $904 | $3K | 20.44% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $694 | $3K | 20.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $422 | $2K | 20.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $401 | $2K | 20.46% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 2711 N HASKEL AVE, STE 2000 DALLAS, TX 752042914 | VISION SERVICE PLAN | $718 | — | $718 | 10.00% |
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 | 124 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 153 | $868K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 62 | $24K |
| Vision | VISION SERVICE PLAN | 54 | $7K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 45 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 45 | $7K |
| Prescription drug | BLUE CROSS BLUE SHIELD | 153 | $868K |
| Other(3 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $54K |
| 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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.