| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | PO BOX 46122 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $51K | $4K | $55K | 6.86% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY, SUITE 80 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $285 | $0 | $285 | 0.04% |
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | PO BOX 46122 EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $83K | $5K | $88K | 21.96% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY, SUITE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 1.29% |
| SWETT & CRAWFORD OF ILLINOIS, INC.3 | ONE NORTH FRANKLIN STREET 14TH FLOOR CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $375 | $0 | $375 | 0.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS WATSON TOWERS MIDWEST, INC. | 233 SOUTH WACKER DRIVE, SUITE 2000 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $362 | $0 | $362 | 0.09% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.00% |
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 | 1,276 | 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) | 1,276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 694 | $44K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,276 | $1.2M |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,276 | $1.2M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,194 | $795K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,276 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,276 | — |
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.