If you have a heated bed, you need to supply power to both the 5A and 11A connections. The 11A connection supplies power for the bed; the 5A connection supplies power for the rest of the electronics.
You're fine having USB and RAMPS power connected at the same. The USB cable will only supply power to the Arduino board, but isn't necessary for operation as the RAMPS board will also supply power to the Arduino.
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