| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| W D CAMPBELL & SON INC3 Filed as: W. D. CAMPBELL AND SON, INC. | PO BOX 677 LYNCHBURG, VA 24505 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | $0 | $12K | 5.57% |
| BEERE & PURVES INC3 Filed as: BEERE AND PURVES, INC. | 500 YGNACIO VALLEY ROAD, SUITE 450 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 1.17% |
| W D CAMPBELL & SON INC3 Filed as: W. D. CAMPBELL AND SON, INC. | 115 SOUTH MAIN STREET LEXINGTON, VA 24450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 9.57% |
| W D CAMPBELL & SON INC3 Filed as: W. D. CAMPBELL AND SON, INC. | 801 MAIN STREET LYNCHBURG, VA 24504 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 10.14% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | -$43 | — | -$43 | -0.16% |
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 | 272 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 27 | $220K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 250 | $27K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 291 | $138K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 291 | $138K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 291 | $138K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 27 | $220K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 291 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.