| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $969 | $3K | 1.85% |
| AHMANN MARTIN3 Filed as: AHMANN & MARTIN CO | 7555 MARKET PLACE DR EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $204 | $2K | 1.57% |
| DAVID MARTIN AGENCY INC3 Filed as: DAVID MARTIN AGENCY INC. | 6800 FRANCE AVE S STE 735 EDINA, MN 55435 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $892 | — | $892 | 0.59% |
| RICHARD J. HEINRICH3 Filed as: RICHARD J. HENDRICH | 13921 BLENHEIM TRAIL ROAD FT MYERS, FL 33908 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $807 | — | $807 | 0.53% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $71 | $71 | 0.05% |
| AHMANN MARTIN3 Filed as: AHMANN AND MARTIN COMPANY | 7555 MARKET PLACE DR EDEN PRAIRIE, MN 553443637 | RELIASTAR LIFE INSURANCE COMPANY | $12K | $0 | $12K | 10.00% |
| DAVID MARTIN AGENCY INC3 Filed as: DAVID MARTIN AGENCY INC. | 6800 FRANCE AVE S., STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 15.00% |
| ASSUREX3 | STE 800 175 S THIRD ST COLUMBUS, OH 43215 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $690 | $690 | 0.75% |
| DAVID MARTIN AGENCY INC3 Filed as: DAVID MARTIN AGENCY INC.. | 6800 FRANCE AVE S., STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $547 | $4K | 5.95% |
| DAVID MARTIN AGENCY INC3 Filed as: DAVID MARTIN AGENCY INC. | 6800 FRANCE AVE S., STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14 | — | $14 | 3.22% |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 210 | $26K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 394 | $244K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 394 | $152K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 427 | $73K |
| Other(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 394 | $361K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 427 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.