| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STRATEBEN INC3 Filed as: STRATEBEN, INC. | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 20814 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 0.50% |
| SIMMONDS, JOHN H3 | 4720 MONTGOMERY LANE SUITE 500 BETHESDA, MD 20814 | HUMANA INSURANCE COMPANY | $22K | — | $22K | 9.11% |
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $627 | — | $627 | 0.50% |
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $359 | — | $359 | 0.50% |
| SIMMONDS, JOHN H3 | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 20814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $155 | — | $155 | 0.50% |
| SIMMONDS, JOHN H3 Filed as: SIMMONDS, JOHN, HARDING | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 20814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $528 | — | $528 | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $170 | — | $170 | 1.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $233 | — | $233 | 1.81% |
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 | 684 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 686 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 284 | $237K |
| Vision | VISION SERVICE PLAN | 424 | $45K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 866 | $197K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $44K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 866 | $125K |
| Stop-loss / reinsurancereinsurance(2 contracts) | HCC LIFE INSURANCE COMPANY | 449 | $991K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 866 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 866 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.