| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $75K | $20K | $94K | 30.63% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES MN | 9655 SCHMIDT LAKE ROAD PLYMOUTH, MN 55442 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13K | — | $13K | 4.07% |
| THE KNM GROUP, LLC3 | 4350 BAKER ROAD, SUITE 250 HOPKINS, MN 55343 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $58 | $1K | $1K | 0.40% |
| BENEFIT ASSOCIATES INC.3 Filed as: BENEFIT ASSOCIATES, INC. | 1008 WEST 8TH AVENUE, SUITE E KING OF PRUSSIA, PA 19406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $669 | — | $669 | 0.22% |
| LORRAINE R MOORE3 Filed as: LORRAINE R. MOORE | 1150 FIRST AVENUE, SUITE 100 KING OF PRUSSIA, MN 55343 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $496 | — | $496 | 0.16% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1250 CAPITAL OF TEXAS HIGHWAY BUILDING 2, SUITE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $240 | $240 | 0.08% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36K | $6K | $42K | 30.19% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES MN | 9655 SCHMIDT LAKE ROAD PLYMOUTH, MN 55442 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $854 | $10K | 6.96% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,731 | $308K |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,731 | $448K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,731 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.