| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY1 | 1920 N. STREET, NW, STE 500 WASHINGTON, DC 20036 | GENWORTH LIFE & ANNUITY INSURANCE | $1K | $1K | $2K | 0.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Contract Administrator Service code 13 | P. O. BOX 1449 GOODLETTSVILLE, TN 37070 | $204K |
| HEALTHKEEPERS, INC EIN 54-1356687 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | 3350 PEACHTREE ST ATLANTA, GA 30326 | $153K |
| THE SEGAL COMPANY EIN 13-2619259 NONE | Consulting (general); Actuarial Service code 11 | 1920 N. STREET NW, STE 400 WASHINGTON, DC 20036 | $110K |
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357129 NONE | Other services; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | 3350 PEACHTREE ST ATLANTA, GA 30326 | $47K |
| SEMO LAW GROUP EIN 47-0959287 NONE | Legal Service code 29 | 1800 M STREET, STE 730 S WASHINGTON, DC 20036 | $41K |
| RICHMOND CAPITAL MANAGEMENT EIN 54-1288566 NONE | Investment management Service code 28 | 10800 MIDLOTHIAN TURNPIKE STE 217 RICHMOND, VA 23235 | $22K |
| DENNIS G. JENKINS LLC EIN 20-5886120 NONE | Accounting (including auditing) Service code 10 | 1690 STONE VILLAGE LN, STE 501 KENNESAW, GA 30152 | $9K |
| WELLS FARGO BANK EIN 94-1347393 NONE | Custodial (securities) Service code 19 | 360 INTERSTATE NORTH PKWAY, STE 500 ATLANTA, GA 30339 | $8K |
| BOND BEEBE EIN 52-1044197 NONE | Accounting (including auditing) Service code 10 | 4600 EAST-WEST HIWAY, STE 900 BETHESDA, MD 20814 | $8K |
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 | 717 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 238 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 955 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | GENWORTH LIFE & ANNUITY INSURANCE | 914 | $248K |
| Other | THE HARTFORD INSURANCE CO | 717 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,171 | — |
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.