| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $85K | $87K | 3.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $13K | $27K | 15.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | $400 | $7K | 5.25% |
| AP BENEFIT ADVISOR3 Filed as: AP BENEFIT ADVISOR LLC | 10 NORTH PARK DRIVE, SUITE 200 HUNT VALLY, MD 21030 | TRANSAMERICA LIFE INSURANCE COMPANY | $161 | $0 | $161 | 3.58% |
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHRUCH, VA 22042 | TRANSAMERICA LIFE INSURANCE COMPANY | $61 | $0 | $61 | 1.36% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 199 | $2.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 121 | $138K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 199 | $2.4M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $173K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $169K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $169K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 199 | $2.4M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.