| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OPTIMA HEALTH PLAN | $3K | $0 | $3K | 0.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $9K | $0 | $9K | 6.14% |
| USI INSURANCE SERVICES LLC3 | 2 22ND STREET, 2ND FLOOR WHEELING, WV 26003 | STANDARD INSURANCE COMPANY | $0 | $3K | $3K | 1.92% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OHIC PPO | $1K | $0 | $1K | 0.94% |
| TIFFANY GODLEY SMITH3 Filed as: TIFFANY G. SMITH | 1136 MASTERS ROW CHESAPEAKE, VA 23320 | AFLAC | $344 | $66 | $410 | 5.54% |
| THE FRIEDEN AGENCY INC3 Filed as: THE FRIEDEN AGENCY LLC | 3 COMMERICAL PLACE, SUITE 1600 NORFOLK, VA 23510 | AFLAC | $346 | $0 | $346 | 4.67% |
| MJ INSURANCE3 Filed as: JULIA E. LEE & VARIOUS AGENTS | 3414 LAGUNA AVENUE OAKLAND, CA 94602 | AFLAC | $85 | $34 | $119 | 1.61% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | AFLAC | $46 | $0 | $46 | 0.62% |
| ANDREA L SHERMAN3 Filed as: ANDREA L. SHERMAN | 1348 FIVE FORKS ROAD VIRGINIA BEACH, VA 23455 | AFLAC | $38 | $0 | $38 | 0.51% |
| ELIZABETH ANNE BUCHANAN3 | 3401 HUNTON RIDGE DRIVE GLEN ALLEN, VA 23059 | AFLAC | $32 | $0 | $32 | 0.43% |
| SHAWN K STEPHENS3 Filed as: SHAWN K. STEPHENS | 1323 GRAHAM TRACE LANE LEAGUE CITY, TX 77573 | AFLAC | $30 | $0 | $30 | 0.41% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | FIDELITY SECURITY LIFE | $375 | $0 | $375 | 15.00% |
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 | 149 | 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) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 201 | $1.2M |
| Dental | STANDARD INSURANCE COMPANY | 149 | $149K |
| Vision | STANDARD INSURANCE COMPANY | 149 | $149K |
| Life insurance | STANDARD INSURANCE COMPANY | 149 | $149K |
| Long-term disability | STANDARD INSURANCE COMPANY | 149 | $149K |
| Prescription drug(2 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 201 | $1.2M |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 149 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.