| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES Filed as: WELLS FARGO INSURANCE SERVICES USA, | P.O. BOX 203491 DALLAS, TX 75320 | ANTHEM BLUE CROSS AND BLUE SHIELD | $41K | — | $41K | 8.29% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES, LLC | 101 WEST MAIN ST. SUITE 900 NORFOLK, VA 23514 | ANTHEM BLUE CROSS AND BLUE SHIELD | $14K | — | $14K | 2.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHKEEPERS, INC EIN 54-1356687 NONE | Contract Administrator; Claims processing; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | PO BOX 26623 RICHMOND, VA 23285 | $301K |
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 NONE | Float revenue; Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | 2015 STAPLES MILL ROAD RICHMOND, VA 23285 | $267K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 NONE | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $50K |
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 | 907 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 921 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHKEEPERS, INC. | 1,062 | $1.0M |
| Vision | ANTHEM BLUE CROSS AND BLUE SHIELD | 1,024 | $497K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,062 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.