| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | BLUE CROSS BLUE SHIELD OF TEXAS | $145K | $162 | $145K | 4.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 4.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $38 | $38 | 0.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 14.06% |
| MERCER HEALTH AND BENEFITS, LLC3 | 15 WEST SOUTH TEMPLE, SUITE 700 SALT LAKE CITY, UT 84101 | AETNA LIFE INSURANCE COMPANY | — | $173 | $173 | 0.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 840 GESSNER, SUITE 600 HOUSTON, TX 77024 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $774 | — | $774 | 9.94% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 898 | $3.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 750 | $28K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 666 | $8K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 407 | $19K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 407 | $19K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 407 | $19K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF TEXAS | 898 | $3.0M |
| Other | AETNA LIFE INSURANCE COMPANY | 407 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 898 | — |
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."
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.