| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BORNRAGER INSURANCE AGENCY3 | 205 SOUTH LIBERTY STREET HARRISONBURG, VA 22801 | OPTIMA HEALTH | $30K | — | $30K | 2.25% |
| BORNTRAGER INSURANCE AGENCY3 | 205 A SOUTH LIBERTY ST HARRISONBURG, VA 22801 | RELIANCE LIFE INSURANCE COMPANY | $3K | — | $3K | 2.78% |
| BORNTRAGER INSURANCE AGENCY3 | 205 A S LIBERTY ST HARRISONBURG, VA 22801 | RELIANCE LIFE INSURANCE COMPANY | $3K | $2K | $6K | 8.59% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE LIFE INSURANCE COMPANY | — | $771 | $771 | 1.17% |
| BORNTRAGER INSURANCE AGENCY3 | 205 A S LIBERTY ST HARRISONBURG, VA 22801 | RELIANCE LIFE INSURANCE COMPANY | $3K | $840 | $4K | 17.16% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE LIFE INSURANCE COMPANY | — | $263 | $263 | 1.18% |
| BORNRAGER INSURANCE AGENCY3 | 205 SOUTH LIBERTY STREET HARRISONBURG, VA 22801 | OPTIMA HEALTH | $227 | — | $227 | 2.25% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | OPTIMA HEALTH | 298 | $1.3M |
| Dental | RELIANCE LIFE INSURANCE COMPANY | 327 | $90K |
| Vision | RELIANCE LIFE INSURANCE COMPANY | 327 | $90K |
| Life insurance | RELIANCE LIFE INSURANCE COMPANY | 212 | $66K |
| Long-term disability | RELIANCE LIFE INSURANCE COMPANY | 211 | $22K |
| Other | RELIANCE LIFE INSURANCE COMPANY | 212 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.