| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND LLC | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | HARTFORD LIFE AND ACCIDENT | $59K | $1K | $60K | 27.53% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VI 20176 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $7K | — | $7K | 21.23% |
| VIRGINIA AUTOMOBILE DEALERS SVCS.3 Filed as: VIRGINIA AUTOMOBILE DEALERS SERVICE | 1800 W GRACE ST. RICHMOND, VA 23220 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $6K | — | $6K | 15.95% |
| BRADLEY W GRAMM3 Filed as: BRADLEY W. GRAMM | 100 EASTSHORE DR., STE. 300 GLEN ALLEN, VA 23059 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $3K | — | $3K | 9.87% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND LLC | 540 FORT EVANS RD. NE., STE. 301 LEESBURG, VA 20176 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 15.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | AMERICAN FIDELITY ASSURANCE COMPANY | $706 | — | $706 | 14.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 BENEFIT ADMINISTRATOR | Claims processing Service code 12 | — | $13K |
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 | 282 | 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) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN FIDELITY ASSURANCE COMPANY | 0 | $5K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 312 | $19K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 282 | $254K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 282 | $224K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 282 | $219K |
| Stop-loss / reinsurancereinsurance | WELLNET HEALTHCARE | 172 | $211K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 282 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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.