| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VIRGINIA AUTOMOBILE DEALERS SVCS.3 | PO BOX 5407 RICHMOND, VA 23220 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $25K | $29K | 4.88% |
| KEYSTONE INS & BFTS GRP LLC3 Filed as: KEYSTONE INS. AND BEN. GROUP, INC. | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $12K | $13K | 2.17% |
| KEYSTONE INS & BFTS GRP LLC3 Filed as: KEYSTONE INS. AND BEN. GROUP, LLC | 1995 POINT TOWNSHIP DRIVE NORTHUMBERLAND, PA 17857 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $0 | $5K | 0.91% |
| VIRGINIA AUTOMOBILE DEALERS SVCS.3 | PO BOX 5407 RICHMOND, VA 23220 | AMERICAN FIDELITY ASSURANCE | $6K | $0 | $6K | 30.26% |
| THE FRIEDEN AGENCY INC3 Filed as: FRIEDEN AGENCY, LLC | 3300 BUILDING, SUITE 108 VIRGINIA BEACH, VA 23452 | ANTHEM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.15% |
| WILLIAM H. TALLEY & SON, INC.3 Filed as: WILLIAM H. TALLEY AND SON, INC. | PO BOX 751 PETERSBURG, VA 23804 | ANTHEM LIFE INSURANCE COMPANY | $996 | $0 | $996 | 7.03% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 321 | $609K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 321 | $589K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 321 | $589K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 137 | $14K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE | 15 | $20K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE | 15 | $20K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 321 | $589K |
| Other | AMERICAN FIDELITY ASSURANCE | 15 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 321 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.