| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| U S I INSURANCE SERVICES, LLC3 Filed as: U S I INSURANCE SERVICES LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF VIRGINIA | $12K | — | $12K | 3.98% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | METROPOLITAN LIFE INSURANCE COMPANY | $37K | $2K | $38K | 26.47% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | P.O. BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 7.48% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $735 | — | $735 | 2.52% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $226 | — | $226 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHKEEPERS, INC. EIN 54-1356687 THIRD PARTY ADMINISTRATO | Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Contract Administrator; Claims processing Service code 12 | — | $134K |
| ANTHEM HEALTH PLANS OF VIRGINIA, IN EIN 54-0357120 THIRD PARTY ADMINISTRATO | Other fees; Other services; Float revenue; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $117K |
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVE RSAA HARTFORD, CT 06156 | $14K |
| HEALTH AND HUMAN RESOURCE CENTER, I PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVE RSAA HARTFORD, CA 06156 | $50 |
| USI INS SERVICES LLC INSURANCE AGENT/BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 300 E MAIN ST STE 1300 NORFOLK, VA 23510 | $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 | 428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 444 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 661 | $505K |
| Dental | DELTA DENTAL OF VIRGINIA | 681 | $307K |
| Vision(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 661 | $534K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $179K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $144K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 661 | $505K |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 681 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.