| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | RELIASTAR LIFE INSURANCE COMPANY | $36K | — | $36K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS AND BLUESHIELD EIN 35-0781558 CLAIMS PROCESSING & OTHER | Claims processing Service code 12 | 1351 WM. HOWARD TAFT RD CINCINNATI, OH 452061721 | $308K |
| RELIASTAR LIFE INSURANCE COMPANY EIN 41-0451140 INSURANCE PROVIDER | Insurance services Service code 23 | 20 WASHINGTON AVE SOUTH MINNEAPOLIS, MN 55401 | $243K |
| MICHELLE M. HOKE PLAN CO-ADMINISTRATOR | Plan Administrator Service code 14 | 303 DUSTYS ROAD COVINGTON, VA 24426 | $90K |
| ANNA M. BROOKS PLAN CO-ADMINISTRATOR | Plan Administrator Service code 14 | 138 FALCON RIDGE ROAD CLIFTON FORGE, VA 24422 | $89K |
| DEBORAH C. MAYS EMPLOYEE | Employee (plan) Service code 30 | 109 MEADOW OF WILSON CT CLIFTON FORGE, VA 24422 | $46K |
| RITA C. WILLIAMS EMPLOYEE | Employee (plan) Service code 30 | 315 CLARK LANE CLIFTON FORGE, VA 24422 | $42K |
| JULIE N. TAYLOR EMPLOYEE | Employee (plan) Service code 30 | 951 GAME TRAIL WAY CLIFTON FORGE, VA 24422 | $40K |
| BRANDY VIA EMPLOYEE | Employee (plan) Service code 30 | PO BOX 18 SELMA, VA 24474 | $37K |
| RODNEY NICELY EMPLOYEE | Employee (plan) Service code 30 | 200 MEADOWDALE ROAD CLIFTON FORGE, VA 24422 | $36K |
| ELIZABETH CRUSH EMPLOYEE | Employee (plan) Service code 30 | 4305 MCKINNEY HOLLOW RD CLIFTON FORGE, VA 24422 | $34K |
| RSUI INDEMNITY COMPANY EIN 16-0366830 INSURANCE PROVIDER | Insurance services Service code 23 | 945 PACES FERRY ROAD ATLANTA, GA 303261160 | $26K |
| ADVENT ADVISORY GROUP PART D DATA VALUATION | Accounting (including auditing) Service code 10 | 1921 23RD TER ASTORIA, NY 111053725 | $16K |
| OGLETREE, DEAKINS, NASH, SMOAK EIN 57-1044820 ATTORNEY | Legal Service code 29 | PO BOX 89 COLUMBIA, SC 29202 | $13K |
| PERSINGER COMPANY CPAS, INC. EIN 27-0593881 ACCOUNTING/AUDITING | Accounting (including auditing) Service code 10 | 501 E. DOLLY ANN DRIVE COVINGTON, VA 24426 | $13K |
| FIRST COMMUNITY BANK TRUST EIN 55-0118830 INVESTMENT MANAGEMENT | Investment management fees paid directly by plan Service code 51 | — | $11K |
| APPLICATION SYSTEMS CONSULTING EIN 26-4685180 CONSULTING | Consulting (general) Service code 16 | 9 TORTUGA LANE TIJERAS, NM 87059 | $10K |
| DSS RESEARCH EIN 75-1886732 PARTICIPANT SURVEY | Participant communication Service code 38 | 4150 INTERNATIONAL PLAZA FORT WORTH, TX 76109 | $10K |
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 | 804 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,103 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,907 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.