| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF VIRGINIA INC | 4951 LAKE BROOK DRIVE SUITE 400 GLEN ALLEN, VA 23060 | AETNA LIFE INSURANCE CO. | $3K | $2K | $5K | 0.46% |
| GARY W GOYER3 | 5463 WINESAP DRIVE ROANOKE, VA 24019 | AFLAC | $13K | $411 | $13K | 17.60% |
| JOHN A HAWLEY3 | 1390 SOUTHSIDE DRIVE SALEM, VA 24153 | AFLAC | $1K | $82 | $1K | 1.97% |
| KEVIN L MARTIN3 | 608 W CARROLLTON AVENUE SALEM, VA 24153 | AFLAC | $1K | $82 | $1K | 1.72% |
| MELVIN R JONES3 | 3025 ELIOCH MANOR DRIVE POWHATAN, VA 23139 | AFLAC | $339 | — | $339 | 0.46% |
| LARRY W OWEN3 | P. O. BOX 783 SALEM, VA 24153 | AFLAC | $295 | — | $295 | 0.40% |
| JACKSON D RHODES3 | 525 W OAKLAND AVE SUITE 7 JOHNSON CITY, TN 37604 | AFLAC | $199 | — | $199 | 0.27% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES R HILL SR. | 9701 GAYTON ROAD SUITE 3 RICHMOND, VA 23238 | AFLAC | $161 | — | $161 | 0.22% |
| BOBBY R CRAIGHEAD3 Filed as: BOBBY CRAIGHEAD | 431 MITCHELL VALLEY DRIVE MARION, VA 24354 | AFLAC | $128 | — | $128 | 0.17% |
| THOMAS E HATCHER JR3 Filed as: THOMAS E HATCHER JR. | 717 GREEN VALLEY ROAD SUITE 200 GREENSBORO, NC 27408 | AFLAC | $89 | — | $89 | 0.12% |
| HEATHER D HAWLEY3 | 212 BISHOP ROAD BLACKSBURG, VA 24060 | AFLAC | $41 | — | $41 | 0.06% |
| TRAVIS B HAWKINS3 | 761 MOSBY ST SW ABINGDON, VA 24210 | AFLAC | $41 | — | $41 | 0.06% |
| SHANE M OWEN3 Filed as: SHANE CRAIG DAVISON | 1300 SHETTER AVE. APT. 4202 JACKSONVILLE BEACH, FL 32250 | AFLAC | $32 | — | $32 | 0.04% |
| BRIAN CUMPTAN3 | 320 9TH STREET SUITE 200 HUNTINGTON, WV 25701 | AFLAC | $27 | $3 | $30 | 0.04% |
| HEATHER D HAWLEY3 | 6744 BAY HILL CT RADFORD, VA 24141 | AFLAC | $26 | — | $26 | 0.04% |
| TRICIA A VANDEVANDER3 | 115 CAMBRIDGE DRIVE DALEVILLE, VA 24083 | AFLAC | $22 | — | $22 | 0.03% |
| C HARVEY KING3 | PO BOX 1370 MT PLEASANT, SC 29465 | AFLAC | $20 | — | $20 | 0.03% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT M GUTHRIE | 5401 ASHBURY CT. TYLER, TX 75703 | AFLAC | $19 | — | $19 | 0.03% |
| JUDY L MCCULLOUGH3 | PO BOX 449 FOREST, VA 24551 | AFLAC | $16 | — | $16 | 0.02% |
| HENRY MOSES3 | 1456 MUD PIKE CHRISTIANSBURG, VA 24073 | AFLAC | $12 | — | $12 | 0.02% |
| DARAN L WYCKOFF3 | 505 N ARGONNE BLDG C SPOKANE VALLEY, WA 99212 | AFLAC | $11 | — | $11 | 0.01% |
| RONALD E KIRKLAND3 | 4 SOTHEBY PL SE GURLEY, AL 35748 | AFLAC | $1 | — | $1 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF VIRGINIA | 4951 LAKE BROOK DRIVE SUITE 300 GLEN ALLEN, VA 23060 | ANTHEM LIFE INSURANCE COMPANY | $8K | — | $8K | 12.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CALIFORNIA | I-801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | ANTHEM LIFE INSURANCE COMPANY | — | $621 | $621 | 1.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF VIRGINIA INC. | 4951 LAKE BROOK DRIVE SUITE 300 GLEN ALLEN, VA 23060 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.78% |
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 | 161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 294 | $1.1M |
| Dental | AETNA LIFE INSURANCE CO. | 294 | $1.1M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 165 | $10K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 157 | $61K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 157 | $61K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 157 | $61K |
| Other | AFLAC | 100 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.