| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | UNITEDHEALTHCARE INSURANCE COMPANY | $56K | $0 | $56K | 2.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $36K | $0 | $36K | 1.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $231 | $10K | 14.30% |
| JOE FERNANDEZ3 | 7500 DALLAS PARKWAY, SUITE 550 PLANO, TX 75024 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $6K | 8.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $938 | $130 | $1K | 1.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 61187 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $81 | $81 | 0.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS, INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $65 | $65 | 0.10% |
| TBX EMPLOYEE BENEFITS LLC3 Filed as: TBX EMPLOYEE BENEFITS | UNKNOWN MOONACHIE, NJ 07074 | COMBINED INSURANCE COMPANY | $8K | $0 | $8K | 54.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC | UNKNOWN MOONACHIE, NJ 07074 | COMBINED INSURANCE COMPANY | $1K | $0 | $1K | 9.20% |
| MASOLI LEGACY LLC4 Filed as: MASOLI LEGACY, LLC | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $310 | $0 | $310 | 10.98% |
| USI INSURANCE SERVICES LLC4 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $78 | $0 | $78 | 2.76% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.0M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.0M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.0M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.0M |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.0M |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.0M |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.0M |
| Other(4 contracts, 4 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 328 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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.