| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $46K | $0 | $46K | 8.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES SOUTHWEST | 840 GESSNER ROAD, SUITE 600 HOUSTON, TX 77024 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | $0 | $16K | 4.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES SOUTHWEST | 2711 NORTH HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $51K | $12K | $63K | 18.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | $0 | $12K | 13.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $6K | $0 | $6K | 9.98% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN MAHWAH, NJ 07430 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
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 | 664 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 33 | $415K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,365 | $522K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,338 | $59K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 667 | $340K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 667 | $340K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 33 | $415K |
| Other(4 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 667 | $428K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,365 | — |
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.