| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 2.46% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, GA 30097 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $929 | $929 | 1.75% |
| DAN J KINCAID3 | 321 MAIN STREET ROCKPORT, IN 47635 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | STARMOUNT LIFE INSURANCE COMPANY | $3K | — | $3K | 5.83% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.86% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $545 | $545 | 1.75% |
| DAN J KINCAID3 | 321 MAIN STREET ROCKPORT, IN 47635 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, GA 30097 | UNUM INSURANCE COMPANY | $3K | — | $3K | 12.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | UNUM INSURANCE COMPANY | $0 | $517 | $517 | 1.90% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, GA 30097 | UNUM INSURANCE COMPANY | $2K | — | $2K | 9.92% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | UNUM INSURANCE COMPANY | $0 | $529 | $529 | 3.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, GA 30097 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 10.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $230 | $230 | 1.79% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, GA 30097 | UNUM INSURANCE COMPANY | $1K | — | $1K | 13.23% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | UNUM INSURANCE COMPANY | $0 | $469 | $469 | 4.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EBMS MEDICAL ADMIN EIN 81-0391256 CLAIMS ADMIN | Claims processing; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $48K |
| MARSH AND MCLENNAN LLC EIN 26-3237576 BROKER | Insurance agents and brokers; Insurance services Service code 22 | — | $34K |
| SENTRY HEALTH EIN 27-3334466 CASE MGMT | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Plan Administrator Service code 12 | — | $13K |
| PROCARE PHARMACY BENEFIT MGR EIN 58-2422694 RX ADMIN FEES | Other insurance fees and expenses Service code 73 | — | $7K |
| MULTIPLAN INC EIN 13-3068979 PPO FEES | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Plan Administrator Service code 12 | — | $4K |
| SWIFTMD EIN 26-1306606 TELEMEDICINE | Other fees Service code 99 | — | $4K |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 143 | $52K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 143 | $52K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 154 | $13K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $96K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 91 | $31K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 154 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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.