| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TERRY HAVENS3 | P O BOX 22318 LEXINGTON, KY 40522 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $80K | — | $80K | 2.50% |
| FLEXVISION - MD3 | 15400 CALHOON DRIVE SUITE 125 ROCKVILLE, MD 20855 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $32K | $32K | 1.00% |
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 | 13,071 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6,834 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 19,905 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 45,570 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 45,570 | — |
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.