| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1301 EAST 9TH STREET, SUITE 3800 CLEVELAND, OH 44114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $6K | $6K | 0.98% |
| USI INSURANCE SERVICES LLC3 | 1 SEAGATE, SUITE 1800 TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $220 | $4K | 0.61% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $193 | $2K | 0.30% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $170 | $2K | 0.30% |
| USI INSURANCE SERVICES LLC3 | 1 SEAGATE, SUITE 1800 TOLEDO, OH 43604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $561 | $10K | 11.82% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $486 | $5K | 5.90% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $420 | $5K | 5.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 1001 LAKESIDE AVENUE, SUITE 1500 CLEVELAND, OH 44114 | ACE AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
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 | 1,006 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 174 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 999 | $1.0M |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 999 | $740K |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,006 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,006 | — |
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.