| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 20.19% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 17.72% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $16K | — | $16K | 43.95% |
| BRADLEY W GRAMM3 Filed as: BRADLEY W. GRAMM | 100 EASTSHORE DR., STE. 300 GLEN ALLEN, VA 230595758 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $4K | — | $4K | 9.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACCOUNTABLE CARE MANAGEMENT GROUP TPA | Contract Administrator; Claims processing Service code 12 | 6802 PARAGON PL., STE. 410 RICHMOND, VA 23230 | $109K |
| HILB GROUP OF MARYLAND BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | $29K |
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 | 191 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 131 | $63K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $70K |
| Life insurance(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 191 | $146K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 191 | $109K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 191 | $109K |
| Stop-loss / reinsurancereinsurance | AMERICAN FIDELITY ASSURANCE COMPANY | 175 | $252K |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 191 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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.