| 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 | $118K | — | $118K | 4.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $83 | $83 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $17K | $12K | $29K | 5.11% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $9K | $7K | $16K | 5.11% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $9K | $7K | $16K | 5.11% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $983 | $2K | $3K | 1.85% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $293 | $3K | $3K | 4.15% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $2K | $1K | $3K | 5.11% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | DEPT. 3383 PO BOX 123383 DALLAS, TX 753123383 | METLIFE LEGAL PLANS | — | $1K | $1K | 1.64% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $2K | $1K | $3K | 5.11% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST, PO BOX 64006 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $2K | $1K | $3K | 5.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | ZURICH AMERICAN INSURANCE COMPANY | $2K | $806 | $3K | 20.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62939 VIRGINIA BEACH, VA 234662939 | ZURICH AMERICAN INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA, INC EIN 48-1298079 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $775K |
| GSA NATIONAL EIN 11-3335620 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $439K |
| 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 | — | $83K |
| HARTFORD LIFE AND ACCIDENT INS. CO. EIN 06-0838648 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | — | $65K |
| CITRIN COOPERMAN & COMPANY, LLP EIN 22-2428965 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | 7900 WESTPARK DRIVE, SUITE A220 MCLEAN, VA 22102 | $36K |
| DISCOVERY BENEFITS, INC. EIN 90-0058554 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $32K |
| BRAIN POWER SOFTWARE LLC THIRD PARTY ADMINISTRATOR | Direct payment from the plan Service code 50 | 113 WAPPOO CREEK DR CHARLESTON, SC 29412 | $27K |
| USI INSURANCE SERVICES EIN 13-3771734 ACTUARY | Direct payment from the plan; Actuarial Service code 11 | — | $26K |
| TRUVERIS, INC. EIN 27-4345686 CONSULTANT | Direct payment from the plan; Consulting (general) Service code 16 | — | $20K |
| AMI MAILING DIRECT MAIL SERVICE | Other services; Direct payment from the plan Service code 49 | 4413 WHEELER AVE ALEXANDRIA, VA 22304 | $11K |
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 | 2,538 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,538 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 3,156 | $3.7M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,195 | $4.1M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,195 | $1.2M |
| Life insurance(3 contracts) | HARTFORD LIFE AND ACCIDENT | 1,906 | $687K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,864 | $563K |
| Prescription drug | PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC | 3,156 | $482K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 1,316 | $623K |
| Other(10 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,906 | $4.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,156 | — |
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.