| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | OPTIMA HEALTH PLAN | $18K | $0 | $18K | 1.20% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 12748 ROANOKE, VA 24028 | OPTIMA HEALTH PLAN | $12K | $0 | $12K | 0.80% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | OHIC PPO | $6K | $0 | $6K | 1.28% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 12748 ROANOKE, VA 24028 | OHIC PPO | $4K | $0 | $4K | 0.72% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $2K | $785 | $2K | 2.09% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $2K | $0 | $2K | 1.48% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 4900 LIBBIE MILL BOULEVARD SUITE 100 RICHMOND, VA 23230 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 5.29% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | PO BOX 11177 SOUTH BEND, IN 46634 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 4.49% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 2301 SUGAR BUSH ROAD, SUITE 600 RALEIGH, NC 27612 | STANDARD INSURANCE COMPANY | $0 | $418 | $418 | 0.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | ANTHEM LIFE INSURANCE COMPANY | $1K | $351 | $2K | 4.70% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 202 SOUTH MICHIGAN STREET SUITE 1400 SOUTH BEND, IN 46601 | ANTHEM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.76% |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 240 | $2.0M |
| Dental | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 375 | $114K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 256 | $37K |
| Long-term disability | STANDARD INSURANCE COMPANY | 92 | $42K |
| Prescription drug | OPTIMA HEALTH PLAN | 240 | $1.5M |
| Other(4 contracts, 4 carriers) | OPTIMA HEALTH PLAN | 375 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.