| 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., SUITE 301 LEESBURG, VA 20176 | DELTA DENTAL OF VIRGINIA | $4K | — | $4K | 5.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., SUITE 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 18.89% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., SUITE 301 LEESBURG, VA 21076 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 22.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 18.17% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | VISION SERVICE PLAN | $820 | — | $820 | 6.74% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., SUITE 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $900 | $474 | $1K | 15.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| STEALTH PARTNERS GROUP EIN 27-0290866 STOP LOSS | Contract Administrator Service code 13 | — | $237K |
| SISCO EIN 42-1144827 THIRD PARTY ADMINISTRATO | Claims processing; Contract Administrator Service code 12 | — | $56K |
| CIGNA EIN 84-0467907 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $19K |
| TELADOC HEALTH EIN 04-3750597 TELEMEDICINE | Contract Administrator; Claims processing Service code 12 | — | $2K |
| AMWINS CONNECT ADMINISTRATORS, INC. EIN 52-1200892 THIRD PARTY ADMINISTRATO | Contract Administrator; Claims processing Service code 12 | — | $581 |
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 | 100 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF VIRGINIA | 219 | $78K |
| Vision | VISION SERVICE PLAN | 76 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $20K |
| Stop-loss / reinsurancereinsurance | PAN-AMERICAN LIFE INSURANCE COMPANY | 97 | $225K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.