| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MID ATLANTIC INSURANCE SERVICES LLC3 | 2903 JEFFERSON DAVIS HWY SANFORD, NC 27330 | ANTHEM HEALTH PLANS OF VIRGINIA, INC | — | — | $0 | 0.00% |
| MID ATLANTIC INSURANCE SERVICES LLC3 | 2903 JEFFERSON DAVIS HWY SANFORD, NC 27330 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 12.12% |
| W D CAMPBELL & SON INC3 Filed as: W D CAMPBELL & SON, INC. | 801 MAIN STREET, SUITE 400 LYNCHBURG, VA 24505 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 6.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 ADMINISTRATOR | Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Other services Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $303K |
| MID ATLANTIC INSURANCE SERVICES LLC EIN 54-2025919 BROKER | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | PO BOX 339 SANFORD, NC 27331 | $0 |
| W D CAMPBELL & SON INC EIN 54-0357120 BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | PO BOX 677 LYNCHBURG, VA 24505 | $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 | 248 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA, INC | 318 | $237K |
| Dental | ANTHEM HEALTH PLANS OF VIRGINIA, INC | 318 | $237K |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA, INC | 318 | $237K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 251 | $20K |
| Prescription drug | ANTHEM HEALTH PLANS OF VIRGINIA, INC | 318 | $237K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA, INC | 318 | $237K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 251 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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.