| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 1753 PINNACLE DRIVE, 8TH FLOOR MCLEAN, VA 22102 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $166K | $42K | $207K | 2.50% |
| WELLS FARGO INSURANCE SERVICES3 | 1753 PINNACLE DRIVE, SUITE 800 MCLEAN, VA 22102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | $10K | $60K | 4.89% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 601478 CHARLOTTE, NC 28260 | UNITED HEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 1.97% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $14K | $24K | 3.27% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203014 DALLAS, TX 75320 | VISION SERVICE PLAN | $2K | — | $2K | 3.78% |
| WELLS FARGO INSURANCE SERVICES3 | UNKNOWN CHARLOTTE, NC 28260 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 | 613 RIVER PARK ROAD BELMONT, NC 28012 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $865 | — | $865 | 8.41% |
| WELLS FARGO INSURANCE SERVICES3 | 1401 H STREET NW, SUITE 750 WASHINGTON, DC 20005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $480 | $18 | $498 | 4.84% |
| WELLS FARGO INSURANCE SERVICES3 | 25 BULL STREET SAVANNAH, GA 31401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC. | 12505 PARKPOTOMAC, SUITE 300 POTOMAC, MD 20854 | FEDERAL INSURANCE COMPANY | $912 | — | $912 | 15.00% |
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 | 738 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 771 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 1,235 | $9.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,298 | $724K |
| Vision | VISION SERVICE PLAN | 403 | $48K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 738 | $1.2M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 738 | $1.2M |
| Prescription drug(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 1,235 | $9.0M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 738 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,298 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.