| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $3K | $8K | 17.48% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $433 | $4K | 15.61% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $83 | $1K | 9.16% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $70 | $0 | $70 | 0.57% |
| SONIA A VIDAL-AWBREY3 Filed as: SONIA A. VIDAL-AWBREY | 2665 PROSPERITY AVENUE APARTMENT 113 FAIRFAX, VA 22031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $52 | $0 | $52 | 0.43% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $52 | $0 | $52 | 0.43% |
| HOWARD W PHILLIPS CO3 Filed as: HOWARD W. PHILLIPS & COMPANY | 80 M STREET SE, SUITE 350 WASHINGTON, DC 20003 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $0 | $79 | 1.43% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.92% |
| SONIA A VIDAL-AWBREY3 Filed as: SONIA A. VIDAL-AWBREY | 2665 PROSPERITY AVENUE APARTMENT 113 FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.87% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.76% |
| CARMEN AIDA CRUZ3 | 2707 SARDIS CHASE COURT BUFORD, GA 30519 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.54% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 0.34% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $45K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $45K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 47 | $43K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 47 | $6K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $26K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 47 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.