| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62949,ATTN WEST VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $130K | $12K | $142K | 12.28% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 61007 VIRGINIA BEACH, VA 23466 | DIRECTCARE HMO | $4K | — | $4K | 1.50% |
| USI INSURANCE SERVICES LLC3 | 101 W MAIN STREET, STE 900 NORFOLK, VA 235101653 | VISION SERVICE PLAN | $1K | — | $1K | 1.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | VISION SERVICE PLAN | $1K | — | $1K | 1.28% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $612 | — | $612 | 15.01% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $386 | $386 | 9.47% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 603036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $64 | $64 | 1.57% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $64 | — | $64 | 1.57% |
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 | 1,474 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,009 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,483 | 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. | 1,708 | $706K |
| Dental | DELTA DENTAL OF VIRGINIA | 2,171 | $514K |
| Vision | VISION SERVICE PLAN | 701 | $80K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 4,361 | $1.2M |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 4,361 | $1.2M |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 1,708 | $706K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 1,708 | $706K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 4,361 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,361 | — |
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.