| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA LLC | PO BOX 6180 CAROL STREAM, IL 601976180 | HARTFORD LIFE AND ACCIDENT | $16K | — | $16K | 9.63% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN | 12421 MEREDITH DRIVE URBANDALE, IA 50398 | HARTFORD LIFE AND ACCIDENT | $993 | — | $993 | 0.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA INC EIN 54-0357120 CLAIMS PROCESSOR | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Contract Administrator; Float revenue 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 | 67 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 67 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | HARTFORD LIFE AND ACCIDENT | 67 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 67 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.