| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1120 MADISON AVENUE TOLEDO, OH 43604 | HEALTHKEEPERS, INC. | $16K | $0 | $16K | 1.78% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | HEALTHKEEPERS, INC. | $1K | $0 | $1K | 0.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1120 MADISON AVENUE TOLEDO, OH 43604 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $8K | $0 | $8K | 1.78% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $3K | $0 | $3K | 0.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $2K | $0 | $2K | 2.80% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $2K | $0 | $2K | 2.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $8K | $6K | $13K | 22.11% |
| DIGITIAL INSURANCE LLC3 Filed as: DIGITIAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | ANTHEM LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.32% |
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 | 351 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHKEEPERS, INC. | 196 | $1.4M |
| Dental | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 180 | $85K |
| Vision(2 contracts, 2 carriers) | HEALTHKEEPERS, INC. | 196 | $1.4M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 267 | $61K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 267 | $61K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 267 | $61K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 267 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.