| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203014 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $53K | $6K | $60K | 2.43% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203014 DALLAS, TX 75320 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $53K | $6K | $60K | 29.89% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $43K | $722 | $44K | 21.90% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $366 | $4K | 1.94% |
| USI INSURANCE SERVICES LLC3 | 1753 PINNACLE DRIVE, SUITE 800 MCLEAN, VA 22102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $468 | $2K | 0.81% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3975 FAIR RIDGE DRIVE, SUITE 110 FAIRFAX, VA 22033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $137 | $0 | $137 | 0.07% |
| USI INSURANCE SERVICES LLC3 | 9020 STONY POINT PARKWAY SUITE 200 RICHMOND, VA 23235 | DOMINION NATIONAL | $4K | $0 | $4K | 8.10% |
| USI INSURANCE SERVICES LLC3 | 4880 COX ROAD SUITE 102 GLEN ALLEN, VA 23060 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $526 | $39 | $565 | 10.74% |
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 | 343 | 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) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 361 | $2.5M |
| Dental | DOMINION NATIONAL | 330 | $45K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $5K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 361 | $2.5M |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,201 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,201 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.