| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $80K | $80K | 2.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $85K | $20K | $105K | 15.87% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN. | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $78 | $0 | $78 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 4840 COX ROAD, SUITE 150 GLEN ALLEN, VA 23060 | UNITEDHEALTHCARE INSURANCE COMPANY | $12K | $0 | $12K | 10.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 2.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS. SERVICES USA, INC. | UNKNOWN ALEXANDRIA, VA 22310 | HARTFORD ACCIDENT AND LIFE INSURANCE COMPANY | $830 | $0 | $830 | 4.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM INSURANCE COMPANY | $1K | $229 | $1K | 18.00% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN. | PO BOX 1313 ORLANDO, FL 32802 | UNUM INSURANCE COMPANY | $152 | $0 | $152 | 1.99% |
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 | 578 | 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) | 578 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 258 | $3.5M |
| Vision | VISION SERVICE PLAN | 329 | $58K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 578 | $660K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 578 | $660K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 578 | $660K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 258 | $3.5M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 578 | $667K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 578 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.