| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER POWELL3 Filed as: CHRISTOPHER W. POWELL | 350 OLD IVY WAY STE 200 CHARLOTTESVILLE, VA 22903 | HIGHMARK WEST VIRGINIA INC | $17K | — | $17K | 3.19% |
| CHARLES ROBINSON3 | PO BOX 10 ONA, WV 25545 | HIGHMARK WEST VIRGINIA INC | -$2K | — | -$2K | -0.36% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | 113 SOUTH WAYNE AVE PO BOX 700 WAYNESBORO, VA 22980 | ANTHEM HEALTH PLANS OF VIRGINIA INC | $11K | — | $11K | 2.76% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | 1425 SIMINOLE TRAIL 2ND FLOOR CHARLOTTESVILLE, VA 22901 | AMERITAS LIFE INSURANCE CORP | $3K | $850 | $4K | 7.20% |
| MOUNTAIN STATE EMPLOYEE BENEFITS3 Filed as: MOUNTAIN STATE EMPLOYEE BENEFITS LL | 103 6TH AVE ST. ALBANS, WV 25177 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $596 | $25 | $621 | 9.35% |
| TERRY SCOTT MATHIAS3 | 1413 SUMMIT LANE CHARLESTON, WV 25301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $206 | — | $206 | 3.10% |
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 | 117 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HIGHMARK WEST VIRGINIA INC | 56 | $931K |
| Dental | AMERITAS LIFE INSURANCE CORP | 93 | $58K |
| Vision | AMERITAS LIFE INSURANCE CORP | 93 | $58K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 13 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 93 | — |
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.