| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OPTIMA HEALTH PLAN | $53K | — | $53K | 2.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $69K | — | $69K | 20.25% |
| VINCE THOMAS CALLAHAN3 | 1126 MAGNOLIA AVENUE NORFOLK, VA 23508 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13K | — | $13K | 3.89% |
| DANNY R. OSTER3 | 11812 SAWGRASS LANE FREDERICKSBURG, VA 22407 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12K | — | $12K | 3.37% |
| JOHN DOTEN3 | 6003 POURING GLORIES WAY CLARKSVILLE, MD 21029 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 2.03% |
| TIMOTHY C CAVAZOS3 Filed as: TIMOTHY MARK SIMMONS | 5405 STANWOOD WAY GLEN ALLEN, VA 23059 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $147 | — | $147 | 0.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA INSURANCE COMPANY | $14K | — | $14K | 5.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OPTIMA HEALTH INSURANCE COMPANY | $5K | — | $5K | 2.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $970 | $370 | $1K | 16.21% |
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 | 567 | 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) | 570 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | OPTIMA HEALTH PLAN | 608 | $3.0M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 865 | $278K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 542 | $349K |
| Prescription drug(2 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 608 | $2.7M |
| Other | ANTHEM LIFE INSURANCE COMPANY | 542 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 865 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.