| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 10 NORTH PARK DR STE 200 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $6K | $9K | 10.47% |
| AP BENEFIT ADVISORS, LLC3 | 10 NORTH PARK DR STE 200 HUNT VALLEY, MD 21030 | UNITED CONCORDIA INSURANCE COMPANY | $8K | $4K | $12K | 14.86% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 NORTH PARK DR STE 200 HUNT VALLEY, MD 21030 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $3K | — | $3K | 12.91% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 435 WHITTINGTON PKWY SUITE 300 LOUISVILLE, KY 40222 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $0 | $166 | $166 | 0.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | -$153 | — | -$153 | -0.71% |
| AP BENEFIT ADVISORS, LLC3 | 10 NORTH PARK DR STE 200 HUNT VALLEY, MD 21030 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $151 | $151 | 1.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | LEGAL RESOURCES | $80 | — | $80 | 0.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 MEDICAL ADMIN FEES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $17K |
| HEALTHKEEPERS, INC. EIN 54-1356687 RX ADMIN FEES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue Service code 12 | — | $0 |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 133 | $79K |
| Vision(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 176 | $35K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $83K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $83K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $83K |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 288 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.