| 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 | $54K | $6K | $60K | 2.39% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $41K | $10K | $51K | 26.49% |
| USI INSURANCE SERVICES LLC3 | 1750 H STREET NW, SUITE 200 WASHINGTON, DC 20006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22K | $2K | $24K | 12.40% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3975 FAIR RIDGE DRIVE, SUITE 110 FAIRFAX, VA 22033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $128 | $0 | $128 | 0.07% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$3K | -$259 | -$4K | -1.93% |
| USI INSURANCE SERVICES LLC3 | 1753 PINNACLE DRIVE, SUITE 800 MCLEAN, VA 22102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$14K | -$878 | -$15K | -7.72% |
| USI INSURANCE SERVICES LLC3 | 9020 STONY POINT PARKWAY, SUITE 200 RICHMOND, VA 23235 | DOMINION NATIONAL | $3K | $0 | $3K | 2.66% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $12K | $42K | 33.22% |
| USI INSURANCE SERVICES LLC3 | 1750 H STREET NW, SUITE 200 WASHINGTON, DC 20006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $1K | $16K | 12.78% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $422 | $44 | $466 | 0.37% |
| USI INSURANCE SERVICES LLC3 | 4880 COX ROAD, SUITE 102 GLEN ALLEN, VA 23060 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $87 | $7 | $94 | 0.07% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3975 FAIR RIDGE DRIVE, SUITE 110 FAIRFAX, VA 22033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $56 | $0 | $56 | 0.04% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$2K | -$169 | -$2K | -1.57% |
| USI INSURANCE SERVICES LLC3 | 1753 PINNACLE DRIVE, SUITE 800 MCLEAN, VA 22102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$10K | -$875 | -$11K | -8.74% |
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 | 294 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 340 | $2.5M |
| Dental | DOMINION NATIONAL | 303 | $127K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,722 | $127K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 340 | $2.5M |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,727 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,727 | — |
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.