| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: LAKESHORE BENEFIR ALLIANCE LLC | 414 MEADOWBROOK LANE BIRMINGHAM, AL 35213 | NATIONWIDE INSURANCE | — | $11K | $11K | 4.96% |
| MD LIVE, INC.3 Filed as: MD LIVE, INC | 13630 NW 8TH STREET, SUITE 205 SUNRISE, FL 33325 | NATIONWIDE INSURANCE | — | $2K | $2K | 0.98% |
| LBA SERVICE LLC3 | 414 MEADOWBROOK LANE BIRMINGHAM, AL 35213 | NATIONWIDE INSURANCE | — | $2K | $2K | 0.96% |
| HARMPON DENNIS BRADSHAW INC3 | 7115 HALCYON SUMMIT DR MONTGOMERY, AL 36117 | NATIONWIDE INSURANCE | — | -$6 | -$6 | -0.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 300 W 10TH STREET WEST POINT, GA 31833 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 19.87% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $19 | $19 | 0.02% |
| ERIS VENTURES LLC3 | 931 MONROE DRIVE ATLANTA, GA 30308 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $4K | $10K | 22.58% |
| REGINALD SCOTT3 | 3699 LENOX RD NE APT 204 ATLANTA, GA 30305 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $4K | $6K | 13.28% |
| MARSH & MCLENNAN AGENCY LLC3 | 300 W 10TH STREET WEST POINT, GA 31833 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $631 | $4K | 8.55% |
| MITCHELL HECTOR MORALES3 | 1264 GABLES VIEW PLACE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $476 | $2K | 4.92% |
| HARMON DENNIS BRADSHAW INC3 | PO BOX 241667 MONTGOMERY, AL 36124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $476 | $3 | $479 | 1.10% |
| ERIN COX3 | 404 DORAL TRCE MONTGOMERY, AL 36116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $225 | — | $225 | 0.52% |
| THOMAS HAYWOOD COWLES3 | 1535 OLD MERIWETHER TRIAL LA PINE, AL 36046 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 0.21% |
| NICOLE D BOWEN3 | 2459 WILLIAMSON RD LUVERNE, AL 36049 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.16% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.13% |
| KATIE H JOHNSON3 | 1106 GRANDWIEW DR KIRKWOOD, MO 63122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.11% |
| DEMPSEY D BELL3 | 17204 STATE HWY 21 BRAGGS, AL 36761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARSH & MCLENNAN AGENCY EIN 75-2734863 NONE | Contract Administrator Service code 13 | — | $28K |
| HEALTHCOMP INTEGRATED SOLUTIONS LLC EIN 72-0519951 NONE | Contract Administrator Service code 13 | — | $17K |
| ACCURISK SOLUTIONS LLC EIN 81-4923899 NONE | Contract Administrator Service code 13 | — | $11K |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 209 | $973K |
| Dental | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 209 | $973K |
| Vision | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 209 | $973K |
| Life insurance(2 contracts, 2 carriers) | NATIONWIDE INSURANCE | 108 | $294K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 106 | $78K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 106 | $78K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 209 | $973K |
| Other(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 209 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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."
No prospect flags tripped on this filing.