| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 2711 NORTH HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | BLUECROSS BLUESHIELD OF TEXAS | $161K | $0 | $161K | 7.20% |
| LG INS MANAGEMENT SVCS LP3 Filed as: LG INS. MANAGEMENT SRVS. | UNKNOWN FORT WORTH, TX 76137 | BLUECROSS BLUESHIELD OF TEXAS | $0 | $4K | $4K | 0.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | DEARBORN LIFE INSURANCE COMPANY | $21K | $0 | $21K | 12.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $806 | $6K | 8.46% |
| LG INS MANAGEMENT SVCS LP3 Filed as: LG INS. MANAGEMENT SRVS. | 12900 PRESTON ROAD, SUITE 1205 DALLAS, TX 75230 | METROPOLITAN LIFE INSURANCE COMPANY | $547 | $0 | $547 | 0.78% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $5K | $0 | $5K | 17.51% |
| LG INS MANAGEMENT SVCS LP3 Filed as: LG INS. MANAGEMENT SRVS. | 12900 PRESTON ROAD, SUITE 1200 DALLAS, TX 75230 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $300 | $0 | $300 | 1.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $1K | $131 | $1K | 11.19% |
| LG INS MANAGEMENT SVCS LP3 Filed as: LG INS. MANAGEMENT SRVS. | 12900 PRESTON ROAD, SUITE 1205 DALLAS, TX 75230 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $104 | $0 | $104 | 0.99% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 328 | $2.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 344 | $81K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 303 | $29K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 229 | $165K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 229 | $165K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 229 | $165K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 328 | $2.2M |
| Other | DEARBORN LIFE INSURANCE COMPANY | 229 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 344 | — |
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.
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.