| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 66119 VIGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $9K | $4K | $13K | 27.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA INC EIN 54-0357120 CONTRACT ADMINISTRATOR | Other commissions; Contract Administrator; Claims processing; Insurance brokerage commissions and fees; Insurance agents and brokers; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $452K |
| MANAGEMENT CONSULTING EIN 54-1244651 EMPLOYER | Contract Administrator; Direct payment from the plan Service code 13 | — | $66K |
| USI INS SERVICES LLC EIN 54-0357120 BROKER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $35K |
| CHARLES W. SNADER, P.C. EIN 54-1873714 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $11K |
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 | 510 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 513 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 392 | $334K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 396 | $46K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 396 | $46K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 396 | $46K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 392 | $334K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 396 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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.