| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 200 W CYPRESS CREEK RD #500 FORT LAUDERDALE, FL 33309 | ANTHEM LIFE INSURANCE COMPANY | $109K | $12K | $121K | 9.84% |
| USI INSURANCE SERVICES LLC3 | 101 W. MAIN STREET, STE 900 NORFOLK, VA 23510 | DIRECTCARE HMO | $4K | — | $4K | 1.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 101 W. MAIN STREET, STE 900 NORFOLK, VA 235101653 | VISION SERVICE PLAN | $2K | — | $2K | 2.98% |
| AXA ASSISTANCE, USA5 | 121 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 603036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $770 | $770 | 18.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | SUITE 400 580 NORTH 4TH STREET COLUMBUS, OH 432152153 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $612 | — | $612 | 15.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 601478 CHARLOTTE, NC 282601478 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $62 | — | $62 | 1.52% |
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 | 1,597 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,063 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,660 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 1,749 | $497K |
| Dental | DELTA DENTAL OF VIRGINIA | 2,233 | $647K |
| Vision | VISION SERVICE PLAN | 695 | $74K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 4,523 | $1.2M |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 4,523 | $1.2M |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 1,749 | $497K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 1,749 | $497K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 4,523 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,523 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.