| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | $19K | $0 | $19K | 2.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 9.84% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 4.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.21% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $5K | $5K | 8.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | STARMOUNT LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM INSURANCE COMPANY | $4K | $0 | $4K | 7.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $742 | $742 | 1.51% |
| STEPHANIE J COHEN3 Filed as: STEPHANIE J. COHEN | 4740 CORRIDOR PLACE, SUITE B BELTSVILLE, MD 20705 | UNUM INSURANCE COMPANY | $558 | $46 | $604 | 1.23% |
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOCIATES | 4740 CORRIDOR PLACE, SUITE B BELTSVILLE, MD 20705 | UNUM INSURANCE COMPANY | $391 | $83 | $474 | 0.96% |
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 | 133 | 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) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 123 | $764K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 85 | $66K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 85 | $66K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 135 | $112K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 135 | $161K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 135 | $112K |
| Prescription drug | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 123 | $764K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 135 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.