| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS CORP OF AMERICA3 Filed as: EMPLOYEE BENEFITS CORPORATION OF AM | 1410 SPRING HILL RD. STE 150 MCLEAN, VA 22102 | INNOVATION HEALTH | $14K | — | $14K | 2.63% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 Filed as: EMPLOYEE BENEFITS CORPORATION OF AM | 1410 SPRING HILL RD. STE 150 MCLEAN, VA 22102 | INNOVATION HEALTH | $7K | — | $7K | 2.61% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 Filed as: EMPLOYEE BENEFITS CORPORATION OF AM | 1410 SPRING HILL RD. STE 150 MCLEAN, VA 22102 | AETNA LIFE INSURANCE CO. | $5K | — | $5K | 2.37% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS & FINANCIAL | 7001 HERITAGE VILLAGE PLAZA STE 100 GAINESVILLE, VA 20155 | AETNA LIFE INSURANCE CO. | $1K | — | $1K | 0.52% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS AND FINANCIA | 7001 HERITAGE PLAZA #100 GAINESVILLE, VA 20155 | DELTA DENTAL OF VIRGINIA | $7K | — | $7K | 4.92% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 Filed as: EMPLOYEE BENEFITS CORPORATION OF AM | 1410 SPRING HILL RD. STE 150 MCLEAN, VA 22102 | AETNA HEALTH, INC. | $3K | — | $3K | 2.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL GROUP BENEFITS & FINANCIAL BROKER | Insurance agents and brokers Service code 22 | 7001 HERITAGE VILLAGE PLAZA STE 100 GAINESVILE, VA 20155 | $55K |
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). |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | INNOVATION HEALTH | 264 | $473K |
| Dental | DELTA DENTAL OF VIRGINIA | 328 | $144K |
| Vision | AETNA LIFE INSURANCE CO. | 264 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.