| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. AGENCY OF VA | 11220 ASSETT LOOP MANASSAS, VA 20109 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $2K | $7K | 9.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. AGENCY OF VA | 11220 ASSETT LOOP MANASSAS, VA 20109 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $688 | $688 | 7.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. AGENCY OF VA | 11220 ASSETT LOOP MANASSAS, VA 20109 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $600 | $600 | 7.65% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. AGENCY OF VA | 11220 ASSETT LOOP MANASSAS, VA 20109 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $802 | $0 | $802 | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $408 | $408 | 7.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. AGENCY OF VA | 11220 ASSETT LOOP MANASSAS, VA 20109 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $703 | $0 | $703 | 14.99% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $346 | $346 | 7.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST EIN 52-1358219 ADMIN | Claims processing Service code 12 | — | $28K |
| BROWN & BROWN INSURANCE AGENCY OF V BROKER | Insurance agents and brokers Service code 22 | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | $28K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $14K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
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 | 80 | 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) | 80 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 140 | $82K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 140 | $82K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 80 | $5K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 80 | $9K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 80 | $8K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 70 | $173K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 80 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.