| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STRATEBEN INC3 Filed as: STRATEBEN, INC. | 4720 MONTGOMERY LANE SUITE 500 BETHESDA, MD 20814 | HCC LIFE INSURANCE COMPANY | — | $2K | $2K | 0.50% |
| SIMMONDS, JOHN H3 | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 20814 | HUMANA INSURANCE COMPANY | $25K | — | $25K | 10.75% |
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $420 | — | $420 | 1.00% |
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $276 | — | $276 | 1.00% |
| SIMMONDS, JOHN H3 | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 20814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $120 | — | $120 | 1.00% |
| SIMMONDS, JOHN H3 Filed as: SIMMONDS, JOHN, HARDING | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 20814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $429 | — | $429 | 3.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $140 | — | $140 | 1.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $163 | — | $163 | 1.59% |
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 | 720 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 722 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 271 | $233K |
| Vision | VISION SERVICE PLAN | 409 | $43K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 416 | $70K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 85 | $22K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 416 | $42K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 395 | $436K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 416 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 416 | — |
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.