| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $55K | — | $55K | 12.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 500 COUNTRY PINE LANE BATTLE CREEK, MI 49015 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 3.24% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $377 | $377 | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | VISION SERVICE PLAN | $2K | — | $2K | 1.04% |
| USI INSURANCE SERVICES LLC3 | 101 W MAIN ST STE 900 NORFOLK, VA 23510 | VISION SERVICE PLAN | $1K | — | $1K | 0.69% |
| USI INSURANCE SERVICES LLC3 | 408 9TH ST HUNTINGTON, WV 25701 | VISION SERVICE PLAN | $709 | — | $709 | 0.48% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $13K | 9.47% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS CHRISTOPHER | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $423 | $6K | 4.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 3.93% |
| RETIREMENT PLANNING SERVICES, INC.3 Filed as: RETIREMENT PLANNING SERVS INC. | 208 GOLDEN OAK CT STE. 121 CHICAGO, IL 234526767 | UNITEDHEALTHCARE INSURANCE COMPANY | $630 | — | $630 | 2.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 606044466 | UNITEDHEALTHCARE INSURANCE COMPANY | $294 | — | $294 | 1.00% |
| RETIREMENT PLANNING SERVICES, INC.3 | 2604 BARRETT STREET, SUITE 100 VIRGINIA BEACH, VA 23452 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $683 | — | $683 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 CONTRACT ADMINISTRATOR | Other commissions; Other fees; Other services; Claims processing; Insurance brokerage commissions and fees; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers Service code 12 | — | $1.1M |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 NONE | Contract Administrator Service code 13 | — | $89K |
| THE PRUDENTIAL INSURANCE CO EIN 22-1211670 ADMINISTRATION SERVICES | Contract Administrator Service code 13 | — | $24K |
| COMPSYCH EIN 35-3739783 THIRD PARTY FEES | Contract Administrator Service code 13 | — | $0 |
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 | 1,014 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,028 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 8 | $36K |
| Vision | VISION SERVICE PLAN | 983 | $146K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,014 | $445K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,014 | $445K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,014 | $445K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,014 | $619K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,014 | — |
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.