| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $32K | $0 | $32K | 2.16% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, 1ST FLOOR FLORHAM PARK, NJ 07932 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 6107 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.84% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF VIRGINIA | $6K | $0 | $6K | 5.93% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 11.85% |
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $406 | $0 | $406 | 4.76% |
| GETTYSBURG BNFTS ADMIN INC3 Filed as: GETTYSBURG BENEFITS ADMIN. INC. | PO BOX 1060 GETTYSBURG, PA 17325 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $285 | $0 | $285 | 3.34% |
| VINCE THOMAS CALLAHAN3 | 6804 ATLANTIC AVENUE VIRGINIA BEACH, VA 23451 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $174 | $0 | $174 | 2.04% |
| BERNADETTE M O'NEIL3 Filed as: BERNADETTE M. ONEILL | 3809 WEST CHESTER PIKE NEWTON SQUARE, PA 19073 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $162 | $0 | $162 | 1.90% |
| ROSS G. WINFIELD3 | 397 LITTLE NECK ROAD, SUITE 200 LITTLE NECK, NY 11363 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | $0 | $7 | 0.08% |
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 | 179 | 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) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 266 | $1.5M |
| Dental | DELTA DENTAL OF VIRGINIA | 350 | $107K |
| Vision(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 330 | $1.5M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $119K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $110K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $110K |
| Prescription drug | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 266 | $1.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.