| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | $9K | $30K | 23.02% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | SENTARA HEALTH PLANS | $4K | — | $4K | 4.92% |
| THE FRIEDEN AGENCY INC3 Filed as: THE FRIEDEN AGENCY LLC | 3 COMMERCIAL PL., STE. 1600 NORFOLK, VA 23510 | SENTARA HEALTH PLANS | $2K | — | $2K | 1.73% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $3K | — | $3K | 5.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | SENTARA HEALTH PLANS | $2K | — | $2K | 3.70% |
| THE FRIEDEN AGENCY INC3 Filed as: THE FRIEDEN AGENCY LLC | 3 COMMERCIAL PL., STE. 1600 NORFOLK, VA 23510 | SENTARA HEALTH PLANS | $1K | — | $1K | 1.75% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | SENTARA HEALTH PLANS | $2K | — | $2K | 4.90% |
| THE FRIEDEN AGENCY INC3 Filed as: THE FRIEDEN AGENCY LLC | 3 COMMERCIAL PL., STE. 1600 NORFOLK, VA 23510 | SENTARA HEALTH PLANS | $592 | — | $592 | 1.75% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $18K | — | $18K | 71.63% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | ASSURITY LIFE INSURANCE COMPANY | $8K | — | $8K | 31.66% |
| CLEARWATER BENEFITS LLC3 Filed as: CLEARWATER BENEFITS, LLC | 1301 S CAPITAL OF TEXAS HWY. STE. B-220 AUSTIN, TX 78746 | ASSURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 17.38% |
| DOMINIC RODRIGUEZ3 | — | ASSURITY LIFE INSURANCE COMPANY | $230 | — | $230 | 0.93% |
| TAILORED WORKSITE SERVICES3 Filed as: TAILORED WORKSITE SERVICES, LLC | 2717 COMMERCIAL CENTER BLVD. STE. E200 KATY, TX 77494 | ASSURITY LIFE INSURANCE COMPANY | $34 | — | $34 | 0.14% |
| MARY THERESA FISHER4 | 898 UNION CHURCH RD. TOWNSEND, DE 19734 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $81 | — | $81 | 6.96% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $73 | — | $73 | 6.28% |
| J KEEBS & ASSOCIATES4 Filed as: J KEEBS & ASSOCIATES LLC | 11184 BIG CANOE JASPER, GA 30143 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $31 | — | $31 | 2.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EDIS EIN 81-4658349 THIRD PARTY ADMINISTRATO | Contract Administrator; Claims processing Service code 12 | — | $28K |
| HILB GROUP OF MARYLAND BROKER | Insurance agents and brokers Service code 22 | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | $5K |
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 | 136 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | SENTARA HEALTH PLANS | 11 | $257K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $131K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $131K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $157K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $131K |
| Other(6 contracts, 4 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $346K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.