| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SUMMIT FINANCIAL GROUP INC.3 Filed as: SUMMIT INSURANCE SERVICES | 204 CATOCTIN CIR. SE LEESBURG, VA 20175 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $107K | — | $107K | 15.61% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS. GROUP INC. | 1 KELLY WAY SPARKS GLENCOE, MD 21152 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $46K | $46K | 6.72% |
| DARIO A. CAMPOLATTARO3 | 204 CATOCTIN CIRCLE SE 2ND FLOOR LEESBURG, VA 20175 | METLIFE | $7K | — | $7K | 6.98% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND | 204 CATOCTIN CIRCLE SE 2ND FLOOR LEESBURG, VA 20175 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 5.73% |
| SUMMIT INS SERVICES LLC3 Filed as: SUMMIT INS. SERVICES LLC | 300 N MAIN STREET MOOREFIELD, WV 26836 | SUN LIFE ASSURANCE COMPANY OF CANADA | $339 | — | $339 | 0.45% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 204 CATOCTIN CIRCLE SE 2ND FLOOR LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 12.93% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 540 FORT EVANS ROAD NE, STE. 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS. CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $206K |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 297 | $786K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 297 | $686K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 237 | $75K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 262 | $120K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 262 | $120K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 297 | $686K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 262 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 297 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.