| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $336 | $38K | $38K | 4.99% |
| EMPLOYEE BENEFITS CORP OF AMERICA3 | 1430 SPRING HILL ROAD, SUITE 320 MCLEAN, VA 22102 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $0 | $8K | $8K | 1.01% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | AETNA LIFE INSURANCE COMPANY | $15K | $0 | $15K | 10.28% |
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, PA 22030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 12.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $976 | $976 | 1.20% |
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | DELTA DENTAL OF VIRGINIA | $4K | $0 | $4K | 4.91% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 20.22% |
| DJA, INC.3 Filed as: DJA INC | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | CONTINENTAL AMERICAN INSURANCE COMPANY | $921 | $0 | $921 | 10.00% |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 169 | $913K |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 170 | $221K |
| Vision(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 169 | $913K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $90K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $81K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $90K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 169 | $767K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.