| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 2711 NORTH HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | BLUE CROSS BLUE SHIELD OF TEXAS | $220K | $26K | $246K | 6.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $47K | $32K | $79K | 23.26% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $18K | $18K | 5.19% |
| USI INSURANCE SERVICES LLC3 | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | DEARBORN LIFE INSURANCE COMPANY | $9K | $0 | $9K | 12.53% |
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 | 727 | 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) | 727 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF TEXAS | 876 | $4.3M |
| Dental | BLUE CROSS BLUE SHIELD OF TEXAS | 876 | $3.9M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 393 | $68K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 727 | $341K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 727 | $341K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 727 | $341K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF TEXAS | 876 | $4.3M |
| Other(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF TEXAS | 876 | $4.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 876 | — |
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.