| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD TOP FLOOR FAIRFAX, VA 22030 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $52K | $817 | $53K | 3.90% |
| EBCA3 Filed as: EBCA GENERAL AGENCY | 1430 SPRING HILL ROAD SUITE 320 MCLEAN, VA 22102 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $10K | $0 | $10K | 0.71% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $3K | $15K | 5.91% |
| EDMONDS JAMES3 | 788 BLACK SWEEP ROAD WARRENTON, VA 20186 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.59% |
| MRM & ASSOCS OF AMERICA LTD3 | 32 OLD HICKORY PITTSBORO, NC 27312 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $757 | $0 | $757 | 3.42% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE FINANCIAL, INC. | 3009 WILMINGTON ROAD SUITE 100 NEW CASTLE, PA 16105 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $313 | $0 | $313 | 1.42% |
| GRESHAM ROY3 | 13880 BRADDOCK ROAD SUITE 206 CENTREVILLE, VA 20121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $124 | $0 | $124 | 0.56% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD FAIRFAX, VA 22030 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | $0 | $22 | 0.10% |
| MICHAEL C WALKER3 Filed as: MICHAEL R. MARTIN | 32 OLD HICKORY PITTSBORO, NC 27312 | TRANSAMERICA | $132 | — | $132 | 1.66% |
| JAMES D EDMONDS3 Filed as: JAMES D. EDMONDS | 788 BLACK SWEEP ROAD WARRENTON, VA 20186 | TRANSAMERICA | $102 | — | $102 | 1.29% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE FINANCIAL, INC. | 3009 WILMINGTON ROAD, SUITE 100 NEW CASTLE, PA 16105 | TRANSAMERICA | $37 | — | $37 | 0.47% |
| ROY GRESHAM3 Filed as: ROY L. GRESHAM | 8698 YOUNG COURT SPRINGFIELD, VA 22153 | TRANSAMERICA | $19 | — | $19 | 0.24% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 168 | $1.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $247K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $247K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $255K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $247K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $247K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 168 | $1.4M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $269K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.