| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $50K | — | $50K | 4.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HEALTHKEEPERS, INC. | $10K | — | $10K | 1.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | PO BOX 203991 DALLAS, TX 75320 | HEALTHKEEPERS, INC. | $2K | — | $2K | 0.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DIRECTCARE HMO | $7K | — | $7K | 2.74% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $5K | — | $5K | 2.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 4.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS OF VIRGINIA. INC. | $434 | — | $434 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | PO BOX 203991 DALLAS, TX 75320 | ANTHEM HEALTH PLANS OF VIRGINIA. INC. | $96 | — | $96 | 0.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $388 | — | $388 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | PO BOX 203991 DALLAS, TX 75320 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $86 | — | $86 | 0.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $51 | — | $51 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | PO BOX 203991 DALLAS, TX 75320 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $11 | — | $11 | 0.27% |
| AXA ASSISTANCE, USA5 | 121 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 603036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $475 | $475 | 22.13% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 601478 CHARLOTTE, NC 282601478 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $323 | — | $323 | 15.05% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 603036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $475 | $475 | 25.73% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 601478 CHARLOTTE, NC 282601478 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $323 | — | $323 | 17.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHKEEPERS, INC. EIN 54-1356687 | Contract Administrator; Claims processing; Other fees; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | PO BOX 27401 RICHMOND, VA 27401 | $579K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $92K |
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 | Other fees; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | PO BOX 27401 RICHMOND, VA 27401 | $36K |
| ANTHEM HEALTH PLANS OF VIRGINIA 54- | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue Service code 12 | — | $0 |
| HEALTHKEEPERS, INC. 54-1356687 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Contract Administrator Service code 12 | — | $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 | 2,028 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,030 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,058 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | HEALTHKEEPERS, INC. | 2,022 | $1.1M |
| Dental | DELTA DENTAL OF VIRGINIA | 3,009 | $831K |
| Vision | VISION SERVICE PLAN | 703 | $167K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 2,978 | $1.2M |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 79 | $55K |
| Prescription drug(5 contracts, 3 carriers) | HEALTHKEEPERS, INC. | 2,022 | $1.1M |
| Stop-loss / reinsurancereinsurance(5 contracts, 3 carriers) | HEALTHKEEPERS, INC. | 2,022 | $1.1M |
| Other(3 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 2,978 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,009 | — |
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.