| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARMON DENNIS BRADSHAW INC3 Filed as: HARMON DENNIS & BRADSHAW INC | 4131 CARMICHAEL RD MONTGOMERY, AL 36106 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.86% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $556 | $556 | 2.93% |
| HARMON DENNIS BRADSHAW INC3 Filed as: HARMON DENNIS & BRADSHAW INC | 4131 CARMICHAEL RD MONTGOMERY, AL 36106 | UNITED OF OMAAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.85% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAAHA LIFE INSURANCE COMPANY | $0 | $518 | $518 | 2.92% |
| HARMON DENNIS BRADSHAW INC3 Filed as: HARMON DENNIS & BRADSHAW INC | 4131 CARMICHAEL RD MONTGOMERY, AL 36106 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 21.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $515 | $515 | 3.00% |
| HARMON DENNIS BRADSHAW INC3 Filed as: HARMON DENNIS & BRADSHAW INC | 4131 CARMICHAEL RD MONTGOMERY, AL 36106 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $942 | $3K | 20.74% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $471 | $471 | 2.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GILSBAR, LLC EIN 72-0519951 NONE | Contract Administrator Service code 13 | — | $15K |
| RESOLUTION REINSURANCE INTERMEDIARI EIN 75-2734863 NONE | Contract Administrator Service code 13 | — | $10K |
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 | 98 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | 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) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 229 | $932K |
| Dental | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 229 | $932K |
| Vision | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 229 | $932K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $34K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 109 | $19K |
| Long-term disability | UNITED OF OMAAHA LIFE INSURANCE COMPANY | 110 | $18K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 229 | $932K |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 229 | $949K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.