| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SIGNIFICA BENEFIT SERVICES, INC.5 | PO BOX 7777 LANCASTER, PA 176047777 | OPTUM HEALTH - UNIMERICA INSURANCE COMPANY | $0 | $243K | $243K | 43.50% |
| INTEGRATED INSURANCE SOLUTIONS3 | 44675 CAPE COURT, SUITE 100 ASHBURN, VA 20147 | OPTUM HEALTH - UNIMERICA INSURANCE COMPANY | $107K | — | $107K | 19.21% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 | 1430 SPRING HILL RD STE 320 MCLEAN, VA 22102 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $17K | — | $17K | 9.85% |
| SIGNIFICA BENEFIT SERVICES, INC.3 | 118 WEST AIRPORT RD LITITZ, PA 17543 | OPTUM HEALTH - UNIMERICA INSURANCE COMPANY | $10K | — | $10K | 19.99% |
| INTEGRATED INSURANCE SOLUTIONS3 | 44675 CAPE COURT, SUITE 100 ASHBURN, VA 20147 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SIGNIFICA BENEFITS SERVICES, INC. EIN 23-2504308 THIRD PARTY ADMINISTRATOR | Plan Administrator; Claims processing Service code 12 | PO BOX 7777 LANCASTER, PA 176047777 | $0 |
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 | 498 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | OPTUM HEALTH - UNIMERICA INSURANCE COMPANY | 498 | $609K |
| Dental | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 317 | $174K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 299 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 498 | — |
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.