| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 101 WEST MAIN STREET, SUITE 900 WORLD TRADE CENTER NORFOLK, VA 23510 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $83K | $208 | $83K | 2.64% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | $24K | $0 | $24K | 11.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF VIRGINIA | $11K | $0 | $11K | 4.94% |
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $1K | $0 | $1K | 1.73% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE INSURANCE COMPANY | $838 | $0 | $838 | 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 | 704 | 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) | 704 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 669 | $3.2M |
| Dental | DELTA DENTAL OF VIRGINIA | 529 | $218K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 213 | $17K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 704 | $222K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 704 | $222K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 704 | $222K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 669 | $3.2M |
| Other | AETNA LIFE INSURANCE COMPANY | 704 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 704 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.