| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | AETNA LIFE INSURANCE CO. | $3K | $2K | $5K | 1.32% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 2340 WINCHESTER, VA 22604 | AETNA LIFE INSURANCE CO. | $547 | — | $547 | 0.16% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADMIN | BLDG. 1, SUITE 100 AUSTIN, TX 78729 | AMERICAN UNITED LIFE INSURANCE COMPANY | $11K | — | $11K | 16.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | STE 190 RALEIGH, NC 27612 | AMERICAN UNITED LIFE INSURANCE COMPANY | — | $6K | $6K | 9.76% |
| JACOB RYAN PENNY3 | 501 FAULCONER DR STE 2D CHARLOTTESVILLE, VA 22903 | NORTHWESTERN MUTUAL | $2K | $618 | $3K | 4.85% |
| MARK KREBS3 | 501 FAULCONER DR STE 2D CHARLOTTESVILLE, VA 22903 | NORTHWESTERN MUTUAL | $2K | $618 | $3K | 4.85% |
| VAN DER HYDE ASSOC INC3 | 3901 WESTERRE PKWY STE 300 RICHMOND, VA 23233 | NORTHWESTERN MUTUAL | $981 | $235 | $1K | 1.92% |
| HOME OFFICE TPA PAYS COMMISSION3 | 5900 O STREET LINCOLN, NE 685102234 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 9.95% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 201 | $1.1M |
| Dental | AETNA LIFE INSURANCE CO. | 201 | $353K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 193 | $12K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 151 | $66K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 151 | $66K |
| Long-term disability | NORTHWESTERN MUTUAL | 142 | $63K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 151 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.