| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE ROAD, SUITE 202 WAUKESHA, WI 53188 | COMMUNITY INSURANCE COMPANY | $32K | $880 | $33K | 4.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | COMMUNITY INSURANCE COMPANY | $0 | $1K | $1K | 0.20% |
| SHAWAN MARQUIS AGENCY INC3 Filed as: SHAWAN-MARQUIS AGENCY INC | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | COMMUNITY INSURANCE COMPANY | -$3K | $0 | -$3K | -0.36% |
| MARGARET M. COLLIGNON3 | 5219 COUNTRY CLUB DRIVE BRENTWOOD, TN 37027 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 11.99% |
| KELLE DAGGETT PERRY3 | 797 OLD CC ROAD PIKEVILLE, TN 37367 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $2 | $42 | 16.09% |
| DENNIS E TRAYWICK3 Filed as: DENNIS E. TRAYWICK | 1325 BLACK ROAD PROSPECT, TN 38477 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $9 | $38 | 14.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 14012 FLORIGOLD DRIVE WINDERMERE, FL 34786 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $5 | $33 | 12.64% |
| INSPIRED INC3 | 50 LAGOSHEN DRIVE MOSCOW, TN 38057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $6 | $17 | 6.51% |
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 | 83 | 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) | 83 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 76 | $720K |
| Dental | COMMUNITY INSURANCE COMPANY | 76 | $720K |
| Vision | COMMUNITY INSURANCE COMPANY | 76 | $720K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 68 | $30K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 68 | $30K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 76 | $720K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 68 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 76 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.