| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 101 WEST MAIN STREET, SUITE 900 NORFOLK, VA 23510 | HEALTHKEEPERS, INC. | $40K | — | $40K | 3.43% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $13K | — | $13K | 9.78% |
| DAVID EMERSON3 Filed as: DAVID C. GOODE | 4880 COX ROAD GLEN ALLEN, VA 23060 | ANTHEM LIFE INSURANCE COMPANY | — | $89 | $89 | 0.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 4880 COX ROAD, SUITE 102 GLEN ALLEN, VA 23060 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $3K | — | $3K | 3.87% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 10.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 4880 COX ROAD, SUITE 102 GLEN ALLEN, VA 23060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HEALTHKEEPERS, INC. | 226 | $1.3M |
| Dental | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 64 | $78K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 177 | $18K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 175 | $131K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 175 | $131K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 175 | $131K |
| Prescription drug(4 contracts, 4 carriers) | HEALTHKEEPERS, INC. | 226 | $1.3M |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 175 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.