| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES A SCOTT & SON INC3 | 1700 BAYBERRY COURT RICHMOND, VA 23226 | HCC LIFE INSURANCE COMPANY | $3K | — | $3K | 2.00% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC, LLC | 2209 GODWIN AVE, SE GRAND RAPIDS, MI 49507 | HCC LIFE INSURANCE COMPANY | -$6 | — | -$6 | -0.00% |
| DURWOOD BOOTH JR3 Filed as: DURWOOD BOOTH JR. | 6231 HIGHAM DRIVE ALEXANDRIA, VA 22310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $788 | — | $788 | 7.16% |
| MARGARET F. GORMAN3 | 2418 N OTTAWA STREET ARLINGTON, VA 22205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.45% |
| BARBARA BAROS3 Filed as: BARBARA B CARDELLICHIO | 3510 WISTERIA WAY CT FAIRFAX, VA 22033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.40% |
| MICHAEL RAY YENCARELLI3 | 2242 MARGRAFF CIRCLE WOODBRIDGE, VA 22191 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.39% |
| LILIENFIELD & ASSOCIATES LLC3 | 1100 HIGGINS PLACE ROCKVILLE, MD 20852 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.28% |
| GREG W WOOLLEY3 Filed as: GREG W. WOOLLEY | 15492 CLIFFVIEW DRIVE MONTCLAIR, VA 22026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.25% |
| EMLYN MARSTELLER IV3 | 412 SUGARLAND MEADOW DRIVE HERNDON, VA 20170 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.22% |
| STEPHEN ROSS WEINSTOCK3 | 1821 MACTAVISH AV RICHMOND, VA 23230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $1 | $16 | 0.15% |
| JOHN E CUMMINGS3 Filed as: JOHN E. CUMMINGS | 204 QUAYSIDE CIR #501 MAITLAND, FL 32751 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.14% |
| DARRYL HYMES3 | 2597 SOUTH HWY A1A MELBOURNE BEACH, FL 32951 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| JAMES A SCOTT & SON INC3 | P.O. BOX 10489 LYNCHBURG, VA 245060489 | MONY LIFE INSURANCE COMPANY OF AMERICA | $823 | — | $823 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | P.O. BOX 30541 SALT LAKE CITY, UT 84130 | $104K |
| JAMES A SCOTT & SON INC EIN 54-0372970 BROKER | Other commissions Service code 55 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | $27K |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 154 | $163K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 136 | $16K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 153 | $164K |
| Other | NATIONAL UNION FIRE INSURANCE COMPANY | 153 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.