| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: JAMES A SCOTT & SON- SCOTT INSURANC | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | QBE INSURANCE GROUP LIMITED | — | $2K | $2K | 0.53% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | STANDARD INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | $277 | — | $277 | 0.29% |
| EMPLOYEE FAMILY PROTECTION INC3 | MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $72 | $1K | 5.79% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $505 | $13 | $518 | 2.39% |
| EMPLOYEE FAMILY PROTECTION INC3 | MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $512 | $17 | $529 | 4.21% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $220 | $3 | $223 | 1.77% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | EYEMED VISION CARE LLC | $1K | — | $1K | 8.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTHKEEPERS, INC. EIN 54-1356687 NONE | Non-monetary compensation; Other services; Other commissions; Claims processing; Insurance brokerage commissions and fees; Insurance agents and brokers; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1351 WILLIAM HOWARD TAFT ROAD CINCINNATI, OH 45206 | $217K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 BENEFIT ADMINISTRATOR | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $7K |
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 | 116 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QBE INSURANCE GROUP LIMITED | 124 | $356K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE LLC | 164 | $14K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 173 | $110K |
| Short-term disability | STANDARD INSURANCE COMPANY | 173 | $97K |
| Long-term disability | STANDARD INSURANCE COMPANY | 173 | $97K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE GROUP LIMITED | 124 | $356K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 87 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.