| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSHUA DRAKE3 | 2021 RICHARD JONES RD STE 200 NASHVILLE, TN 37215 | HEALTH ALLIANCE MEDICAL PLANS | $33K | — | $33K | 3.46% |
| LOMAN-RAY INSURANCE GROUP3 | PO BOX 200 BROADLANDS, IL 61816 | COMPANION LIFE INSURANCE COMPANY | $12K | — | $12K | 9.79% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 2.75% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1305 WALT WHITMAN RD. STE 310 MELVILLE, NY 11747 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 2.15% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 143 | $962K |
| Dental | COMPANION LIFE INSURANCE COMPANY | 126 | $124K |
| Vision | COMPANION LIFE INSURANCE COMPANY | 126 | $124K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 126 | $124K |
| Long-term disability | COMPANION LIFE INSURANCE COMPANY | 126 | $124K |
| Other | COMPANION LIFE INSURANCE COMPANY | 126 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.