| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS CORP OF AMERICA3 | 1410 SPRING HILL RD, SUITE 150 MCLEAN, VA 22102 | INNOVATIVE HEALTH | $4K | — | $4K | 1.54% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 | 1410 SPRING HILL RD MCLEAN, VA 22102 | INNOVATIVE HEALTH | — | — | $0 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ MT DONAHOE & ASSOC | 9755 PATUXENT DR, SUITE 250 COLUMBIA, MD 21046 | DENTA QUEST | $4K | — | $4K | 9.14% |
| DOUG WALLACE INSURANCE AGENCY3 | 775 STATION ST HERNDON, VA 20170 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 9.44% |
| DOUG WALLACE INSURANCE AGENCY3 | 775 STATION ST HERNDON, VA 22070 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.17% |
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 | 222 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INNOVATIVE HEALTH | 36 | $253K |
| Dental | DENTA QUEST | 157 | $48K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $37K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 222 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.