| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS CORP OF AMERICA3 | 1410 SPRING HILL ROAD STE 150 MCLEAN, VA 22102 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $5K | $2K | $8K | 9.27% |
| GARY COX3 | 22 JEFFERSON DRIVE POTOMAC FALLS, VA 20165 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $190 | $1K | 5.93% |
| GARY COX3 | 22 JEFFERSON DRIVE POTOMAC FALLS, VA 20165 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $921 | $179 | $1K | 5.97% |
| GARY COX3 | 22 JEFFERSON DRIVE POTOMAC FALLS, VA 20165 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $746 | $144 | $890 | 5.96% |
| GARY COX3 | 22 JEFFERSON DRIVE POTOMAC FALLS, VA 20165 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $369 | $54 | $423 | 5.72% |
| GARY COX3 | 22 JEFFERSON DRIVE POTOMAC FALLS, VA 20165 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $989 | — | $989 | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $330 | $65 | $395 | 5.99% |
| COX, GARY3 | 22 JEFFERSON DRIVE POTOMAC FALLS, VA 20165 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $233 | — | $233 | 14.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $78 | $11 | $89 | 5.72% |
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 | 178 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 392 | $84K |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 392 | $84K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 107 | $20K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $18K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $15K |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 107 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 392 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.