| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DESIGN BENEFITS INC3 | 902 EAST JEFFERSON STREET SUITE 101 CHARLOTTESVILLE, VA 22902 | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | $19K | — | $19K | 25.95% |
| DESIGN BENEFITS INC3 | PO BOX 6009 2676 GARTH ROAD CHARLOTTESVILLE, VA 22901 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 10.00% |
| FLORENCE A ADAMS3 Filed as: FLORENCE ADAMS | PO BOX 54 PRATTS, VA 22731 | AFLAC | $2K | $73 | $2K | 6.62% |
| ANGELA T ADAMS3 Filed as: ANGELA ADAMS | PO BOX 495 MADISON, VA 22727 | AFLAC | $681 | $31 | $712 | 2.70% |
| JOSHUA C BURTON3 Filed as: JOSHUA BURTON | 4198 COX ROAD SUITE 113 GLEN ALLEN, VA 23060 | AFLAC | $292 | $18 | $310 | 1.18% |
| FLOYD E JONES III3 Filed as: FLOYD JONES | 6513 HANOVER AVENUE RICHMOND, VA 23226 | AFLAC | $271 | — | $271 | 1.03% |
| DUANE A ADAMS3 Filed as: DUANE ADAMS | 493 BAILEY DRIVE LOUISA, VA 23093 | AFLAC | $215 | — | $215 | 0.82% |
| STEPHANIE SHEPPA3 Filed as: STEPHANIE VANHOUTEN | 189 RIVER PLACE DUNNSVILLE, VA 22454 | AFLAC | $126 | — | $126 | 0.48% |
| DAVID HARLESS3 | 3412 MANOR GROVE CIRCLE GLEN ALLEN, VA 23059 | AFLAC | $108 | — | $108 | 0.41% |
| FELICIA BAKER3 | 2819 NORTH PARHAM ROAD SUITE 240 RICHMOND, VA 23294 | AFLAC | $74 | $18 | $92 | 0.35% |
| LISA M STINNETT3 Filed as: LISA STINNETT | 4136 OLD SPPRINGFIELD ROAD GLEN ALLEN, VA 23060 | AFLAC | $84 | — | $84 | 0.32% |
| SARAH H MCNEMAR3 Filed as: SARAH MCNEMAR | 1123 PELHAM STREET CULPEPER, VA 22701 | AFLAC | $70 | — | $70 | 0.27% |
| THOMAS ROBINSON3 | 81 COTTAGE COURT GORDONSVILLE, VA 22942 | AFLAC | $51 | — | $51 | 0.19% |
| MARK WARE3 | 310 SHOREWOOD DRIVE MINERAL, VA 23117 | AFLAC | $37 | — | $37 | 0.14% |
| SHANE ANDY KINNER3 Filed as: SHANE KINNER | 10129 ASHLEY MANOR LANE MECHANICSVILLE, VA 23116 | AFLAC | $37 | — | $37 | 0.14% |
| RONALD W MARTIN3 Filed as: RONALD MARTIN | 13312 CHESDIN LANDING DRIVE CHESTERFIELD, VA 23838 | AFLAC | $31 | — | $31 | 0.12% |
| ANGELA DUNN3 | 3750 CRAB ORCHARD ROAD KEYSVILLE, VA 23947 | AFLAC | $30 | — | $30 | 0.11% |
| CHRISTOPHER PARSONS3 | 1925 CUBA LANE HAYES, VA 23072 | AFLAC | $29 | — | $29 | 0.11% |
| BRITTA MARTIN3 | 13312 CHESDIN LANDING DRIVE CHESTERFIELD, VA 23838 | AFLAC | $27 | — | $27 | 0.10% |
| GENIA ANNE TENCH3 Filed as: GENIA TENCH | 10337 NEW BRITTON ROAD MECHANICSVILLE, VA 23116 | AFLAC | $26 | — | $26 | 0.10% |
| DAVID MORGAN3 | 240 BEVERLY HILLS CIRCLE APARTMENT 532 LYNCHBURG, VA 24502 | AFLAC | $19 | — | $19 | 0.07% |
| GEORGE O GREENE3 Filed as: GEORGE GREENE | 10941 GRANADA ROAD RICHMOND, VA 23235 | AFLAC | $17 | — | $17 | 0.06% |
| MARK D LUTHER3 Filed as: MARK LUTHER | 300 LOOP ROAD SHERWOOD, AR 72120 | AFLAC | $15 | — | $15 | 0.06% |
| DARLENE H TUCKER3 Filed as: DARLENE TUCKER | PO BOX 366 MADISON, VA 22727 | AFLAC | $11 | — | $11 | 0.04% |
| JEFFREY N TUCKER3 Filed as: JEFFREY TUCKER | PO BOX 366 5184 SOUTH SEMINOLE TRAIL MADISON, VA 22727 | AFLAC | $11 | — | $11 | 0.04% |
| GREGORY D HILL3 Filed as: GREGORY HILL | 16142 SWALLOWTAIL PLACE MIDLOTHIAN, VA 23113 | AFLAC | $10 | — | $10 | 0.04% |
| DANIEL M SMITH3 Filed as: DANIEL SMITH | 12820 WEST CREEK PARKWAY SUITE K RICHMOND, VA 23238 | AFLAC | $9 | — | $9 | 0.03% |
| HORTENSE HANCOCK3 | 105 DEVLIN LANE MADISON, MS 39110 | AFLAC | $9 | — | $9 | 0.03% |
| RICHARD L MARTIN3 | ROUTE 3 BOX 63 DILLWYN, VA 23936 | AFLAC | $9 | — | $9 | 0.03% |
| CHRISTOPHER W ROBERTS3 Filed as: CHRISTOPHER ROBERTS | 2474 GREEN POINT LANE DENVER, NC 28037 | AFLAC | $8 | — | $8 | 0.03% |
| FRANCES SHAFFER3 | 14025 TOWER ROAD SMITHBURG, MD 21783 | AFLAC | $7 | — | $7 | 0.03% |
| STEVEN KAISER3 | 6447 IVY SPRINGS DRIVE FLOWERY BRANCH, GA 30542 | AFLAC | $7 | — | $7 | 0.03% |
| MICHAEL FATHERREE3 | 171 COUNTY ROAD 1559 ALBA, TX 75410 | AFLAC | $6 | — | $6 | 0.02% |
| BENJAMIN O THOMPSON SR3 Filed as: BENJAMIN THOMPSON SR | 2012 GAMELAW COURT MIDLOTHIAN, VA 23113 | AFLAC | $6 | — | $6 | 0.02% |
| JEANNETTE FATHERREE3 | 171 COUNTY ROAD 1559 ALBA, TX 75410 | AFLAC | $3 | — | $3 | 0.01% |
| NICHOLAS WAGNER3 | 6000 FAIRVIEW ROAD SUITE 470 CHARLOTTE, NC 28210 | AFLAC | $3 | — | $3 | 0.01% |
| AMELIA MORGAN3 | 240 BEVERLY HILLS CIRCLE APARTMENT 532 LYNCHBURG, VA 24502 | AFLAC | $2 | — | $2 | 0.01% |
| SHELVIA RASNIC3 | 4955 HUROP ROAD SANDSTON, VA 23150 | AFLAC | $2 | — | $2 | 0.01% |
| RUSSELL TINNEY3 | 3440 TORRINGTON WAY APARTMENT 7 FAYETTEVILLE, VA 28314 | AFLAC | $1 | — | $1 | 0.00% |
| LANCE PITTMAN LLC3 | 125 LITTLE HAWK PLACE MIDLOTHIAN, VA 23114 | AFLAC | $1 | — | $1 | 0.00% |
| RICHARD KRESINSKE3 | 4004 ATLANTIC AVENUE APARTMENT 803 VIRGINIA BEACH, VA 23451 | AFLAC | $1 | — | $1 | 0.00% |
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 | 78 | 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) | 78 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHKEEPERS, INC. | 79 | $1.2M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 63 | $61K |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 79 | $73K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 94 | $125K |
| Short-term disability | AFLAC | 48 | $26K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 94 | $98K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 94 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 94 | — |
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."
No prospect flags tripped on this filing.