| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $87K | $44K | $131K | 6.28% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 541362142 | UNITEDHEALTHCARE INSURANCE COMPANY | $17K | — | $17K | 5.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $10K | $3K | $12K | 7.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE EIN 36-2739571 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $2.3M |
| BLUE ADVANTAGE EIN 71-0226428 NONE | Other fees Service code 99 | — | $274K |
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 | 4,340 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE CO | 386 | $852K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 6,010 | $337K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,851 | $2.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 4,851 | $2.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 4,235 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,010 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.