| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1120 MADISON AVENUE TOLEDO, OH 43604 | HEALTHKEEPERS, INC. | $20K | — | $20K | 1.93% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $22K | $4K | $26K | 28.95% |
| BERNADETTE M O'NEIL3 Filed as: BERNADETTE M. ONEILL | 3809 WEST CHESTER PIKE, SUITE 190 NEWTOWN SQUARE, PA 19073 | ANTHEM LIFE INSURANCE COMPANY | -$7K | — | -$7K | -7.32% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF VIRGINIA | $4K | — | $4K | 4.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $862 | — | $862 | 9.16% |
| VINCE THOMAS CALLAHAN3 | 6804 ATLANTIC AVENUE VIRGINIA BEACH, VA 23451 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $369 | — | $369 | 3.92% |
| GETTYSBURG BENEFITS ADMINISTRATORS3 | PO BOX 1060 GETTYSBURG, PA 17325 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $346 | — | $346 | 3.68% |
| BERNADETTE M O'NEIL3 Filed as: BERNADETTE M. ONEILL | 3809 WEST CHESTER PIKE, SUITE 190 NEWTON SQUARE, PA 19073 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $198 | — | $198 | 2.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $2K | — | $2K | 18.50% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHKEEPERS, INC. | 261 | $1.1M |
| Dental | DELTA DENTAL OF VIRGINIA | 290 | $75K |
| Vision | EYEMED VISION CARE | 283 | $9K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 141 | $99K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 141 | $90K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 141 | $90K |
| Prescription drug | HEALTHKEEPERS, INC. | 261 | $1.1M |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 141 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.