| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRUM ADVISORS3 Filed as: INTEGRUM ADVISORS LLC | 1800 WEST GRACE STREET RICHMOND, VA 23220 | OPTIMA HEALTH PLAN | $7K | $0 | $7K | 1.74% |
| VIRGINIA AUTOMOBILE DEALERS SVCS.3 Filed as: VIRGINIA AUTOMOBILE DEALERS SVCS | PO BOX 5407 RICHMOND, VA 23220 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 25.00% |
| VIRGINIA AUTOMOBILE DEALERS SVCS.3 Filed as: VIRGINIA AUTOMOBILE DEALERS | PO BOX 5407 RICHMOND, VA 23220 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| INTEGRUM ADVISORS3 Filed as: INTEGRUM ADVISORS LLC | 1800 WEST GRACE STREET RICHMOND, VA 23220 | OHIC PPO | $101 | $0 | $101 | 0.52% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 93 | $410K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 63 | $39K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 63 | $39K |
| Life insurance | BOSTON MUTUAL LIFE INSURANCE COMPANY | 97 | $45K |
| Short-term disability | BOSTON MUTUAL LIFE INSURANCE COMPANY | 97 | $45K |
| Long-term disability | BOSTON MUTUAL LIFE INSURANCE COMPANY | 97 | $45K |
| Prescription drug(2 contracts, 2 carriers) | OPTIMA HEALTH PLAN | 93 | $410K |
| Other | BOSTON MUTUAL LIFE INSURANCE COMPANY | 97 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.