| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPSTONE PRIVATE WEALTH LLC3 | 7639 LEESBURG PIKE FALLS CHURCH, VA 22043 | CAREFIRST BLUECHOICE, INC. | — | $15K | $15K | 1.13% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 Filed as: EMPLOYEE BENEFITS CORP AMERICA | 1410 SPRING HILL ROAD SUITE 150 MCLEAN, VA 22102 | CAREFIRST BLUECHOICE, INC. | — | $8K | $8K | 0.60% |
| CAPSTONE PRIVATE WEALTH LLC3 | 7639 LEESBURG PIKE # A FALLS CHURCH, VA 22043 | PRINCIPAL LIFE INSURANCE COMPANY | $18K | $8K | $26K | 12.63% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | — | $15K | $15K | 7.35% |
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 | 141 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 90 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 135 | $204K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 135 | $204K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 135 | $204K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 135 | $204K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 90 | $1.3M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 135 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.