| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNITEDHEALTHCARE INSURANCE COMPANY | $765 | $26K | $27K | 1.60% |
| DJA, INC.3 Filed as: DJA INC | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNITEDHEALTHCARE INSURANCE COMPANY | $616 | $21K | $21K | 1.28% |
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $880 | $880 | 0.05% |
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNITED CONCORDIA INSURANCE COMPANY | $8K | $0 | $8K | 9.21% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | UNITED CONCORDIA INSURANCE COMPANY | $726 | $0 | $726 | 0.85% |
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, PA 22030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $2K | $11K | 13.10% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $986 | $986 | 1.18% |
| GREG W WOOLLEY3 Filed as: GREG WOOLLEY | 15492 CLIFFVIEW DRIVE MONTCLAIR, VA 22025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 17.13% |
| MULLANEY ENTERPRISES LLC3 Filed as: MULLANEY ENTERPROSES LLC | 5501TWIN KNOLLS ROAD, SUITE 106 COLUMBIA, MD 21045 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $919 | $2K | 10.77% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $126 | $2K | 8.00% |
| EMLYN MARSTELLER IV3 Filed as: EMLYN MARSTELLER | 412 SUGARLAND MEADOW DRIVE HERNDON, VA 20170 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $270 | $22 | $292 | 1.33% |
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, PA 22030 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $132 | $0 | $132 | 0.60% |
| MJ INSURANCE3 Filed as: AMY COHEN AND VARIOUS AGENTS | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $110 | $9 | $119 | 0.54% |
| INSPIRED INC3 | 50 LAGOSHEN DRIVE MOSCOW, TN 38057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $56 | $30 | $86 | 0.39% |
| THE BUSINESS BENEFITS GROUP, INC.3 | 4069 CHAIN BRIDGE ROAD, TOP FLOOR FAIRFAX, VA 22030 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $974 | $0 | $974 | 5.67% |
| PATRIOT GROWTH INSURANCE SERVICES4 | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 18.09% |
| ROGERS BENEFIT GROUP INC4 Filed as: M ROGERS GROUP LLC | PO BOX 853 GEORGETOWN, CO 80444 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $249 | $0 | $249 | 3.34% |
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 | 136 | 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) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 198 | $1.7M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 210 | $85K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 214 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $84K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $84K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $84K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 198 | $1.7M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.