| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER Filed as: COTTINGHAM & BUTLER INS SERVICE | 800 MAIN ST DUBUQUE, IA 52001 | FAIR AMERICAN | $38K | — | $38K | 10.00% |
| FREDERICK STERLING BOLYARD3 | 3959 ELECTRIC RD STE 460 ROANOKE, VA 24018 | NORTHWESTERN MUTUAL | $4K | $954 | $5K | 5.54% |
| CHRISTINE E MILLER3 | 2322 BLUE STONE HILLS DR STE 160 HARRISONBURG, VA 22801 | NORTHWESTERN MUTUAL | $378 | $136 | $514 | 0.60% |
| VAN DER HYDE ASSOC INC3 | 3901 WESTERRE PKWY STE 300 RICHMOND, VA 23233 | NORTHWESTERN MUTUAL | $378 | $45 | $423 | 0.49% |
| COTTINGHAM & BUTLER Filed as: COTTINGHAM & BUTLER INS SERVICE | 800 MAIN ST DUBUQUE, IA 52001 | AMERITAS | $6K | — | $6K | 8.00% |
| FREDERICK STERLING BOLYARD3 | 3959 ELECTRIC RD STE 460 ROANOKE, VA 24018 | NORTHWESTERN MUTUAL | $4K | $945 | $5K | 6.94% |
| CHRISTINE E MILLER3 | 2322 BLUE STONE HILLS DR STE 160 HARRISONBURG, VA 22801 | NORTHWESTERN MUTUAL | $375 | $134 | $509 | 0.75% |
| VAN DER HYDE ASSOC INC3 | 3901 WESTERRE PKWY STE 300 RICHMOND, VA 23233 | NORTHWESTERN MUTUAL | $375 | $45 | $420 | 0.62% |
| FREDERICK STERLING BOLYARD3 | 3959 ELECTRIC RD STE 460 ROANOKE, VA 24018 | NORTHWESTERN MUTUAL | $3K | $850 | $4K | 16.43% |
| CHRISTINE E MILLER3 | 2322 BLUE STONE HILLS DR STE 160 HARRISONBURG, VA 22801 | NORTHWESTERN MUTUAL | $337 | $121 | $458 | 1.78% |
| VAN DER HYDE ASSOC INC3 | 3901 WESTERRE PKWY STE 300 RICHMOND, VA 23233 | NORTHWESTERN MUTUAL | $337 | $40 | $377 | 1.47% |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS | 453 | $81K |
| Vision | AMERITAS | 453 | $81K |
| Life insurance | NORTHWESTERN MUTUAL | 307 | $68K |
| Short-term disability | NORTHWESTERN MUTUAL | 305 | $86K |
| Long-term disability | NORTHWESTERN MUTUAL | 102 | $26K |
| Stop-loss / reinsurancereinsurance | FAIR AMERICAN | 131 | $376K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 453 | — |
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.