| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERITAIN HEALTH3 | 300 CORPORATE PARKWAY AMHERST, NY 14226 | HCC LIFE INSURANCE COMPANY | $3K | — | $3K | 1.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI, SW, INC. - DALLAS | 2711 N. HASKELL AVE, STE 2000 DALLAS, TX 75204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $815 | $20K | 26.06% |
| USI INSURANCE SERVICES LLC3 Filed as: USI, SW, INC. - DALLAS | 2711 N. HASKELL AVE, STE 2000 DALLAS, TX 75204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $748 | $18K | 26.06% |
| TOTAL BENEFIT SOLUTIONS3 | 7412 UNIVERSITY AVE UNIT 1 LUBBOCK, TX 79423 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 15.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SW, INC. - DALLAS | 2711 N. HASKELL AVE, STE 2000 DALLAS, TX 75204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $816 | $7K | 14.03% |
| DAVIS ALLEN AGENCY INC3 Filed as: DAVIS ALLEN AGENCY INC. | 7412 UNIVERSITY AVE UNIT 1 LUBBOCK, TX 79423 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $627 | $627 | 1.26% |
| ENTRUST AGENCIES INC3 Filed as: ENTRUST AGENCIES INC. | 22322 GRAND CORNER DR., STE 200 KATY, TX 77494 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30 | — | $30 | 0.06% |
| TOTAL BENEFIT SOLUTIONS3 | 7412 UNIVERSITY AVENUE UNIT 1 LUBBOCK, TX 79423 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 54.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SW, INC. - DALLAS | 2711 N. HASKELL AVE, STE 2000 DALLAS, TX 75204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $676 | $8K | 39.28% |
| DAVIS ALLEN AGENCY INC3 | 7412 UNIVERSITY AVE UNIT 1 LUBBOCK, TX 79423 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 6.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI, SW, INC. - DALLAS | 2711 N. HASKELL AVE, STE 350 DALLAS, TX 75204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $558 | $60 | $618 | 11.07% |
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 | 284 | 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) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 267 | $334K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 293 | $97K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 146 | $77K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 146 | $77K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 293 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.