| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RUTHERFOORD FINANCIAL SERVICES | FAIRVIEW ROAD STE 230 CHARLOTTE, NC 28210 | AETNA LIFE INSURANCE CO | $10K | — | $10K | 24.46% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | AETNA LIFE INSURANCE CO | $1K | — | $1K | 3.30% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $443 | — | $443 | 10.01% |
| DELTA DENTAL OF VIRGINIA5 | 4818 STARKEY ROAD ROANOKE, VA 24018 | DELTA DENTAL OF VIRGINIA | — | $465 | $465 | 12.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RUTHERFOORD FINANCIAL SERVICES EIN 54-1473229 | Contract Administrator; Claims processing; Consulting (general) Service code 12 | ATTN PEGGY SCHMIDT ONE SOUTH JEFFERSON STREET ROANOKE, VA 24011 | $10K |
| JAMES A SCOTT & SON INC EIN 54-0372970 | Claims processing; Insurance brokerage commissions and fees; Consulting (general); Other commissions; Insurance agents and brokers; Contract Administrator Service code 12 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | $2K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $465 |
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 | 187 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHKEEPERS INC | 170 | $348K |
| Dental | DELTA DENTAL OF VIRGINIA | 187 | $4K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 158 | $4K |
| Life insurance | AETNA LIFE INSURANCE CO | 183 | $40K |
| Short-term disability | AETNA LIFE INSURANCE CO | 183 | $40K |
| Long-term disability | AETNA LIFE INSURANCE CO | 183 | $40K |
| Other | AETNA LIFE INSURANCE CO | 183 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.