| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | RUTHERFOORD AGENCY PO BOX 12748 ROANOKE, VI 24028 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 3.11% |
| RUTHERFORD FINANCIAL SERVICES INC.3 Filed as: RUTHFOORD FINANCIAL SERVICES INC | 1001 HAXALL POINT SUITE 800 RICHMOND, VA 23219 | STANDARD INSURANCE COMPANY | $969 | $501 | $1K | 1.90% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | RUTHERFOORD AGENCY PO BOX 12748 ROANOKE, VA 24028 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 3.53% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RUTHERFOORD FINANCIAL SERVICES INC | 1001 HAXALL POINT SUITE 800 RICHMOND, VA 23219 | STANDARD INSURANCE COMPANY | $796 | $429 | $1K | 1.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLEANNAN AGENCY LLC | RUTHERFOORD AGENCY PO BOX 12748 ROANOKE, VA 24028 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 9.88% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RUTHERFOORD FINANCIAL SERVICES INC | 1001 HAXALL POINT SUITE 800 RICHMOND, VA 23219 | STANDARD INSURANCE COMPANY | $387 | $124 | $511 | 2.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | — | $217K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 240188542 | $9K |
| CIGNA | Participant communication; Other commissions; Named fiduciary; Other services; Non-monetary compensation; Claims processing; Contract Administrator; Float revenue; Direct payment from the plan Service code 12 | — | $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 | 222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 227 | $77K |
| Short-term disability | STANDARD INSURANCE COMPANY | 206 | $62K |
| Long-term disability | STANDARD INSURANCE COMPANY | 88 | $17K |
| Stop-loss / reinsurancereinsurance | TRANSAMERICA LIFE | 194 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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.