| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ MT DONAHOE & ASSOC LLC | 9755 PATUXENT WOODS DRIVE SUITE 250 COLUMBIA, MD 21046 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $49K | $2K | $51K | 1.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 702 KING FARM BOULEVARD SUITE 210 ROCKVILLE, MD 20850 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | — | $14K | 5.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 15800 CRABBS BRANCH WAY #350 ROCKVILLE, MD 20855 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $142 | $142 | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 15800 CRABBS BRANCH WAY #350 ROCKVILLE, MD 20855 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $191 | $191 | 0.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 15800 CRABBS BRANCH WAY #350 ROCKVILLE, MD 20855 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $167 | $167 | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 702 KING FARM BOULEVARD SUITE 210 ROCKVILLE, MD 20850 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $59 | $59 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | FOUR EVER LIFE INSURANCE COMPANY | $816 | $408 | $1K | 6.00% |
| ANTHEM INSURANCE COMPANIES, INC.3 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INSURANCE COMPANY | $816 | $408 | $1K | 6.00% |
No Schedule C service providers reported on this filing.
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 | 628 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 628 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 344 | $4.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,038 | $300K |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 344 | $3.9M |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 592 | $109K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 588 | $69K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 371 | $69K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 592 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,038 | — |
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.