| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 1445 ROSS AVENUE SUITE 4200 DALLAS, TX 75202 | BLUE CROSS BLUE SHIELD OF TEXAS | $57K | $2K | $59K | 3.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 1445 ROSS AVENUE SUITE 4200 DALLAS, TX 75202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $5K | $12K | 7.02% |
| USI INSURANCE SERVICES LLC Filed as: USI SOUTHWEST INC | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.73% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | 2711 N. HASKELL AVEN SUITE 2000 DALLAS, TX 75204 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 16.24% |
| USI INSURANCE SERVICES LLC3 Filed as: BAL PARTNERS OF TEXAS DBA USI | 1445 ROSS AVENUE SUITE 4200 DALLAS, TX 75202 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY/SUPERIOR VISION | $3K | — | $3K | 10.91% |
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 | 208 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 362 | $1.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 184 | $171K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY/SUPERIOR VISION | 347 | $24K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 184 | $171K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 208 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.