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| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA DBA EIN 54-0357120 ADMINISTRATIVE AGREEMENT | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue Service code 12 | — | $202K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 BENEFIT ADMINISTRATOR | Contract Administrator Service code 13 | — | $38K |
| HEALTHKEEPERS, INC EIN 54-1356687 ADMINISTRATIVE AGREEMENT | Contract Administrator; Other services; Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $21K |
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 | 919 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 922 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHKEEPERS, INC. | 719 | $21K |
| Dental | DELTA DENTAL OF VIRGINIA | 977 | $0 |
| Vision(4 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 561 | $51K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF NORTH AMERICA | 919 | $370K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF NORTH AMERICA | 333 | $228K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF NORTH AMERICA | 333 | $228K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 547 | $1.0M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF NORTH AMERICA | 919 | $370K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 977 | — |
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.