| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE FOLEY INSURANCE AGENCY, INC.3 Filed as: THE FOLEY INSURANCE AGENCY INC | 8 SPRING HOUSE INNOVATION PARK SUITE 202 AMBLER, PA 19002 | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | $26K | $0 | $26K | 1.60% |
| THE FOLEY INSURANCE AGENCY, INC.3 Filed as: THE FOLEY INSURANCE AGENCY INC | 8 SPRING HOUSE INNOVATION PARK SUITE 202 AMBLER, PA 19002 | DELTA DENTAL OF VIRGINIA | $10K | $0 | $10K | 7.07% |
| THE FOLEY INSURANCE AGENCY, INC.3 Filed as: THE FOLEY INSURANCE AGENCY INC | 8 SPRING HOUSE INNOVATION PARK SUITE 202 AMBLER, PA 19002 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 10.57% |
| THE FOLEY INSURANCE AGENCY, INC.3 Filed as: THE FOLEY INSURANCE AGENCY INC | 8 SPRING HOUSE INNOVATION PARK SUITE 202 LOWER GWYNEDD, PA 19002 | METLIFE LEGAL PLANS | $2K | $0 | $2K | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVENUE, SUITE 200 ST. PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $1K | $0 | $1K | 9.25% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201, BUILDING 1, SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | $0 | $785 | $785 | 5.00% |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 344 | $1.6M |
| Dental | DELTA DENTAL OF VIRGINIA | 348 | $141K |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 344 | $1.6M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $120K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $120K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $120K |
| Prescription drug | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 344 | $1.6M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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.