| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | P.O. BOX 1490 JACKSON, MS 392151490 | COMPANION LIFE INSURANCE COMPANY | $178K | — | $178K | 6.00% |
| PHILADELPHIA INSURANCE AGENCY3 Filed as: PHILADELPHIA SECURITY INSURANCE | 802 KOSCIUKSO RD PHILADELPHIA, MS 39350 | COMPANION LIFE INSURANCE COMPANY | $118K | — | $118K | 4.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE | P.O. BOX 1490 JACKSON, MS 392151490 | UNITED OF OMAHA LIFE INSURANCE CO | $77K | $13K | $90K | 10.49% |
| PHILADELPHIA INSURANCE AGENCY3 | P.O. BOX 89 PHILADELPHIA, MS 393500089 | UNITED OF OMAHA LIFE INSURANCE CO | $51K | — | $51K | 6.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | P.O. BOX 1490 JACKSON, MS 392151490 | UNITED OF OMAHA LIFE INSURANCE CO | $76K | $13K | $89K | 10.51% |
| PHILADELPHIA INSURANCE AGENCY3 | P.O. BOX 89 PHILADELPHIA, MS 393500089 | UNITED OF OMAHA LIFE INSURANCE CO | $51K | — | $51K | 6.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | P.O. BOX 14790 JACKSON, MS 392151490 | UNITED OF OMAHA LIFE INSURANCE CO | $50K | $13K | $63K | 11.28% |
| PHILADELPHIA INSURANCE AGENCY3 | P.O. BOX 89 PHILADELPHIA, MS 39350 | UNITED OF OMAHA LIFE INSURANCE CO | $34K | — | $34K | 6.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INS INC | P.O. BOX 1490 JACKSON, MS 392151490 | NATIONAL GUARDIAN LIFE | $49K | — | $49K | 9.94% |
| ALLEN D HARDY3 | P.O. BOX 89 PHILADELPHIA, MS 39350 | NATIONAL GUARDIAN LIFE | $33K | — | $33K | 6.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE | P.O. BOX 1490 JACKSON, MS 392151490 | MUTUAL OF OMAHA | $29K | — | $29K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | P.O. BOX 1490 JACKSON, MS 392151490 | UNITED OF OMAHA LIFE INSURANCE CO | $11K | $3K | $14K | 11.48% |
| PHILADELPHIA INSURANCE AGENCY3 | P.O. BOX 89 PHILADELPHIA, MS 393500089 | UNITED OF OMAHA LIFE INSURANCE CO | $7K | — | $7K | 6.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE | P.O. BOX 1490 JACKSON, MS 392151490 | UNITED OF OMAHA LIFE INSURANCE CO | $6K | $1K | $7K | 10.65% |
| PHILADELPHIA INSURANCE AGENCY3 | P.O. BOX 89 PHILADELPHIA, MS 39350 | UNITED OF OMAHA LIFE INSURANCE CO | $4K | — | $4K | 6.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE | P.O. BOX 1490 JACKSON, MS 392151490 | MUTUAL OF OMAHA | $587 | — | $587 | 15.00% |
| PAM FILES3 Filed as: PAM GREGORY | 248 E CAPITOL ST JACKSON, MS 38201 | BLUE CROSS BLUE SHIELD OF TN | $2K | — | $2K | — |
| ALLEN HARDY3 | 802 KOSCIUSKA PHILADELPHIA, MS 39350 | BLUE CROSS BLUE SHIELD OF TN | $1K | — | $1K | — |
| PAM FILES3 Filed as: PAM GREGORY | 248 E CAPITOL ST JACKSON, MS 38201 | BLUE CROSS BLUE SHIELD OF TN | $64K | — | $64K | — |
| ALLEN HARDY3 | 802 KOSCIUSKO PHILADELPHIA, MS 39350 | BLUE CROSS BLUE SHIELD OF TN | $24K | — | $24K | — |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INS AGENCY | 248 E CAPITOL ST JACKSON, MS 39201 | DELTA DENTAL | $17K | — | $17K | — |
| PHILADELPHIA INS AGENCY3 | 802 KOSCIUSKO PHILADELPHIA, MS 38350 | DELTA DENTAL | $11K | — | $11K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHEILD OF TN EIN 62-0427913 CONTRACT ADMNISTRATOR | Contract Administrator Service code 13 | — | $2.1M |
| DELTA DENTAL EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $160K |
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 | 8,742 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 8,742 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | NATIONAL GUARDIAN LIFE | 8,129 | $497K |
| Dental | DELTA DENTAL | 9,206 | $0 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE CO | 5,100 | $1.4M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 3,703 | $858K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 246 | $67K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 4,266 | $3.0M |
| Other(3 contracts, 2 carriers) | MUTUAL OF OMAHA | 246 | $319K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,206 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.