| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP, LLC | 18700 N. HAYDEN RD., STE. 405 SCOTTSDALE, AZ 85255 | PAN AMERICAN LIFE INSURANCE COMPANY | — | $16K | $16K | 7.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | DELTA DENTAL OF VIRGINIA | $4K | — | $4K | 5.02% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $682 | $3K | 13.52% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 21076 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $565 | $2K | 13.44% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | STRYDEN, INC. | $784 | — | $784 | 6.98% |
| SISCO3 | P.O. BOX 389 DUBUQUE, IA 52004 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $867 | $307 | $1K | 13.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SISCO EIN 42-1144827 THIRD PARTY ADMINISTRATO | Claims processing; Contract Administrator Service code 12 | — | $50K |
| CIGNA EIN 84-0467907 PROVIDER NETWORK | Contract Administrator Service code 13 | — | $18K |
| BUTLER HEALTHCORP EIN 42-1403200 CASE MANAGEMENT | Contract Administrator; Claims processing Service code 12 | — | $4K |
| TELADOC HEALTH EIN 04-3750597 TELEMEDICINE | Contract Administrator; Claims processing Service code 12 | — | $3K |
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 | 96 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF VIRGINIA | 217 | $79K |
| Vision | STRYDEN, INC. | 217 | $11K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $25K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $19K |
| Stop-loss / reinsurancereinsurance | PAN AMERICAN LIFE INSURANCE COMPANY | 90 | $227K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 187 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.