| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $18K | — | $18K | 0.87% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 | 1410 SPRING HILL RD STE 150 MCLEAN, VA 22102 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $8K | — | $8K | 0.36% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | PO BOX 948 HENRIETTA, NY 14467 | DELTA DENTAL OF VIRGINIA | $5K | — | $5K | 3.82% |
| SILBERSTEIN INSURANCE GROUP3 Filed as: SILBERSTEIN INSURANCE GROUP LLC | 2850 QUARRY LAKE DRIVE # 303 BALTIMORE, MD 21209 | DELTA DENTAL OF VIRGINIA | $1K | — | $1K | 1.17% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 289 | $2.1M |
| Dental | DELTA DENTAL OF VIRGINIA | 315 | $120K |
| Vision | VISION SERVICE PLAN | 123 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.