| 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 | — | $104K | $104K | 4.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $16K | $22K | 1.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62939 VIRGINIA BEACH, VA 234662939 | METROPOLITAN LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $43K | $15K | $58K | 10.36% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $23K | $8K | $30K | 10.36% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $22K | $8K | $30K | 10.36% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $659 | $5K | $6K | 3.39% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $327 | $3K | $3K | 3.55% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | DEPT. 3383 PO BOX 123383 DALLAS, TX 753123383 | METLIFE LEGAL PLANS | — | $782 | $782 | 1.06% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $5K | $2K | $7K | 10.36% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $4K | $1K | $6K | 10.36% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $4K | $1K | $5K | 10.36% |
| REUBEN WARNER ASSOCIATES, INC. | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | $2K | $642 | $3K | 19.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA, INC EIN 48-1298079 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $881K |
| GSA NATIONAL EIN 11-3335620 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $499K |
| BENEFITFOCUS.COM, INC. EIN 57-1099948 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $108K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $76K |
| HARTFORD LIFE AND ACCIDENT INS. CO. EIN 06-0838648 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $74K |
| CITRIN COOPERMAN & COMPANY, LLP EIN 22-2428965 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | 7900 WESTPARK DRIVE, SUITE A220 MCLEAN, VA 22102 | $35K |
| FLIMP MEDIA VIDEO/FILM PRODUCTION | Direct payment from the plan; Other services Service code 49 | 2 HAYDEN ROWE ST HOOPKINTON, MA 01748 | $24K |
| BRAIN POWER SOFTWARE LLC THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 113 WAPPOO CREEK DR CHARLESTON, SC 29412 | $23K |
| 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 | — | $19K |
| AMI MAILING DIRECE MAIL SERVICE | Direct payment from the plan; Other services Service code 49 | 4413 WHEELER AVE ALEXANDRIA, VA 22304 | $12K |
| BANK OF AMERICA EIN 94-1687665 BANKING/TRUST SERVICES | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $9K |
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 | 2,720 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,728 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 688 | $3.0M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,290 | $3.9M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,290 | $1.2M |
| Life insurance(3 contracts) | HARTFORD LIFE AND ACCIDENT | 2,154 | $652K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,123 | $558K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 1,299 | $668K |
| Other(10 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,155 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,155 | — |
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.