| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203991 DALLAS, TX 75320 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $5K | — | $5K | 1.11% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 18TH FLOOR SAINT LOUIS PARK, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $27 | $11K | 10.13% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 2.00% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS, MN 55426 | EYEMED VISION CARE | $537 | — | $537 | 9.14% |
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 | 78 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 84 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 117 | $465K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $110K |
| Vision | EYEMED VISION CARE | 97 | $6K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $110K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $110K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $110K |
| Prescription drug | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 117 | $465K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.