| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINTON, MN 55437 | UNITEDHEALTHCARE INSURANCE COMPANY | $69K | $0 | $69K | 3.36% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVE, 6TH FLOOR NEW YORK, NY 10016 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $11K | $11K | 0.52% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $11K | $27K | 7.58% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $0 | $16K | 4.41% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MINNESOTA | $14K | $0 | $14K | 9.10% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 14.43% |
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 | 244 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 278 | $2.0M |
| Dental | DELTA DENTAL OF MINNESOTA | 346 | $153K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 438 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $352K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $352K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $352K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 278 | $2.0M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $352K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 438 | — |
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.
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.