| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GCG FINANCIAL LLC3 | THREE PARKWAY NORTH STE 500 DEERFIELD, IL 60015 | ANTHEM LIFE INSURANCE COMPANY | $34K | — | $34K | 22.43% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL RD LYNCHBURG, VA 24502 | ANTHEM LIFE INSURANCE COMPANY | $14K | — | $14K | 9.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $443K |
| GCG FINANCIAL, LLC EIN 81-4473358 BROKER | Other commissions Service code 55 | — | $167K |
| WEX EIN 01-0526993 ADMIN FEES | Contract Administrator; Claims processing Service code 12 | — | $8K |
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 | 671 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 676 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM LIFE INSURANCE COMPANY | 1,276 | $433K |
| Vision | ANTHEM LIFE INSURANCE COMPANY | 1,276 | $433K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 620 | $154K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 555 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,276 | — |
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.