| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERITAIN HEALTH3 | 300 CORPORATE PARKWAY AMHERST, NY 14226 | HCC LIFE INSURANCE COMPANY | $3K | — | $3K | 0.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SWZ STOPLOSS PURCHASING PROGRAM | 2711 N. HASKELL AVE., SUITE 2000 DALLAS, TX 75204 | HCC LIFE INSURANCE COMPANY | $965 | — | $965 | 0.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI, SW, INC. - DALLAS | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $590 | $20K | 25.75% |
| TOTAL BENEFIT SOLUTIONS3 | 7412 UNIVERSITY AVE UNIT 1 LUBBOCK, TX 79423 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 11.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SW, INC. - DALLAS | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $480 | $7K | 10.22% |
| DAVIS ALLEN AGENCY INC3 Filed as: DAVIS ALLEN AGENCY INC. | 7412 UNIVERSITY AVE UNIT 1 LUBBOCK, TX 79423 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $519 | $519 | 0.81% |
| ENTRUST AGENCIES INC3 Filed as: ENTRUST AGENCIES INC. | 22322 GRAND CORNER DR., STE 200 KATY, TX 77494 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26 | — | $26 | 0.04% |
| TOTAL BENEFIT SOLUTIONS3 | 7412 UNIVERSITY AVENUE UNIT 1 LUBBOCK, TX 79423 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 16.27% |
| USI INSURANCE SERVICES LLC Filed as: USI SW, INC. - DALLAS | PO BOX 61187 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $9 | $2K | 10.89% |
| DAVIS ALLEN AGENCY INC3 | 7412 UNIVERSITY AVE UNIT 1 LUBBOCK, TX 79423 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $76 | $76 | 0.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES CORP | 200 SUMMIT LAKE DR. STE. 350 VALHALLA, NY 10595 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $48 | $48 | 0.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI, SW, INC. - DALLAS | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $630 | $47 | $677 | 10.74% |
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 | 315 | 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) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 289 | $375K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 305 | $29K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $79K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $79K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 310 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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.