| 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 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $67K | $25K | $92K | 3.51% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3427 NORFOLK, VA 23514 | AETNA LIFE INSURANCE COMPANY | $9K | — | $9K | 4.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | AETNA LIFE INSURANCE COMPANY | $9K | — | $9K | 3.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 312 ELM STREET, 24TH FLOOR CINNCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | $7K | — | $7K | 3.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 NE 3RD AVENUE, SUITE 610 FORT LAUDERDALE, FL 33301 | AETNA LIFE INSURANCE COMPANY | — | $92 | $92 | 0.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF VIRGINIA | $8K | — | $8K | 4.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE INSURANCE COMPANY | $819 | — | $819 | 5.00% |
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 | 503 | 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) | 503 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 597 | $2.6M |
| Dental | DELTA DENTAL OF VIRGINIA | 477 | $170K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 310 | $16K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 668 | $221K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 668 | $221K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 668 | $221K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 597 | $2.6M |
| Other | AETNA LIFE INSURANCE COMPANY | 668 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 668 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.