| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA CITY, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.50% |
| CONNIE SHADLEY4 | 14139 WEST CORNELL AVENUE LAKEWOOD, CO 80228 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $636 | — | $636 | 16.48% |
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 | 412 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 955 | $3.8M |
| Vision | VISION SERVICE PLAN | 297 | $63K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $367K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $367K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $367K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 955 | $3.8M |
| Other(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 955 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 955 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.