| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE., #50 CHARLESTON, WV 25304 | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | $42K | — | $42K | 2.53% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, #50 CHARLESTON, WV 25304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $4K | $12K | 14.71% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF WEST VIRGINIA | 3601 MACCORKLE AVE. SE, #50 CHARLESTON, WV 25304 | COMPANION LIFE INSURANCE | $3K | — | $3K | 9.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 THIRD PARTY ADMINISTRATO | Contract Administrator; Claims processing Service code 12 | — | $17K |
| HILB GROUP OF WEST VIRGINIA EIN 38-3942599 BROKER | Other commissions; Insurance agents and brokers Service code 22 | — | $4K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 DATA PROCESSING | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $2K |
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 | 240 | 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) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 166 | $1.6M |
| Life insurance | COMPANION LIFE INSURANCE | 24 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 228 | $79K |
| Other | COMPANION LIFE INSURANCE | 24 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.