| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MANAGED BENEFITS, INC.3 | 4900 COX ROAD SUITE 170 GLEN ALLEN, VA 23060 | ANTHEM LIFE INSURANCE COMPANY | $10K | — | $10K | 8.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHKEEPERS, INC. EIN 54-1356687 RECORDKEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance brokerage commissions and fees; Claims processing; Other commissions; Contract Administrator; Insurance agents and brokers; Float revenue Service code 12 | — | $153K |
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 RECORDKEEPER | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services Service code 12 | — | $133K |
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 | 583 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 583 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 583 | $127K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 583 | $127K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA | 781 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 781 | — |
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.