| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | HARTFORD LIFE AND ACCIDENT | $27K | $0 | $27K | 5.60% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123103 DALLAS, TX 75312 | HARTFORD LIFE AND ACCIDENT | $21K | $0 | $21K | 4.41% |
| USI INSURANCE SERVICES LLC3 | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $0 | $11K | $11K | 2.35% |
| USI INSURANCE SERVICES LLC3 | PO BOX 203508 DALLAS, TX 75320 | HUMANADENTAL INSURANCE COMPANY | $20K | $4K | $24K | 10.45% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | HUMANADENTAL INSURANCE COMPANY | $10K | $0 | $10K | 4.40% |
| USI INSURANCE SERVICES LLC3 | PO BOX 203508 DALLAS, TX 75320 | HUMANA INSURANCE COMPANY | $7K | $3K | $10K | 26.03% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | HUMANA INSURANCE COMPANY | $3K | $0 | $3K | 8.97% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | COMMUNITY EYE CARE | $2K | $0 | $2K | 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 | 477 | 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) | 477 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | HUMANADENTAL INSURANCE COMPANY | 188 | $263K |
| Vision | COMMUNITY EYE CARE | 660 | $17K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 477 | $475K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 477 | $475K |
| Other | HARTFORD LIFE AND ACCIDENT | 477 | $475K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 660 | — |
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.