| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $84K | $84K | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION ST STE 1000 SEATTLE, WA 98101 | PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC | $0 | $6K | $6K | 0.35% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO. | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC | $0 | $2K | $2K | 0.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | METROPOLITAN LIFE INSURANCE COMPANY | $38K | $89 | $38K | 3.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62939 VIRGINIA BEACH, VA 234662939 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $28 | $28 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | 601 UNION ST STE 1000 SEATTLE, WA 98101 | PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC | $0 | $3K | $3K | 0.34% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO. | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC | $0 | $1K | $1K | 0.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 6100 FAIRVIEW RD STE 1400 CHARLOTTE, NC 282103293 | SYMETRA LIFE INSURANCE COMPANY | — | $11K | $11K | 1.27% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST STE 900 PORTLAND, OR 97209 | SYMETRA LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $42K | $16K | $58K | 8.84% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $23K | $8K | $31K | 8.84% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $22K | $8K | $31K | 8.84% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $887 | $4K | $5K | 2.57% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $511 | $2K | $3K | 2.69% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $6K | $2K | $8K | 8.84% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $4K | $2K | $6K | 8.84% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | DEPT. 3383 PO BOX 123383 DALLAS, TX 753123383 | METLIFE LEGAL PLANS | — | $670 | $670 | 1.14% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | METLIFE LEGAL PLANS | — | $455 | $455 | 0.77% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $4K | $1K | $5K | 8.84% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $2K | $614 | $2K | 8.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $514K |
| GSA NATIONAL EIN 11-3335620 THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $508K |
| BENEFITFOCUS.COM, INC. EIN 57-1099948 THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $119K |
| CITRIN COOPERMAN & COMPANY, LLP EIN 22-2428965 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | 3998 FAIR RIDGE DR SUITE 360 FAIRFAX, VA 22033 | $30K |
| DISCOVERY BENEFITS, INC. EIN 90-0058554 THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $16K |
| BRAIN POWER SOFTWARE LLC THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 113 WAPPOO CREEK DR CHARLESTON, SC 29412 | $8K |
| HARTFORD LIFE AND ACCIDENT INS. CO. EIN 06-0838648 CLAIMS PROCESSING | Claims processing Service code 12 | ONE HARTFORLD PLAZA HARTFORD, CT 06155 | $6K |
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 | 3,156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,138 | $5.2M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,562 | $3.5M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 2,562 | $1.2M |
| Life insurance(3 contracts) | HARTFORD LIFE AND ACCIDENT | 2,193 | $787K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,166 | $656K |
| Prescription drug | PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC | 84 | $1.8M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,298 | $844K |
| Other(12 contracts, 6 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,193 | $4.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,562 | — |
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."
No prospect flags tripped on this filing.