| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SERVICES, INC | 901 MARQUETTE AVE - STE 1800 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $63K | — | $63K | 11.81% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS, LLC | 2000 CHAPEL VIEW BLVD- STE 240 CRANSTON, RI 02920 | HARTFORD LIFE AND ACCIDENT | $29K | — | $29K | 5.48% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SERVICES, INC | 100 RIALTO PLACE - STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 0.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERV-C LEATHAM | 2290 LUCIEN WAY MAITLAND, FL 32751 | DELTA DENTAL OF MINNESOTA | $9K | — | $9K | 3.97% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC.-CHARLES LEATHAM | 901 MARQUETTE AVE., SUITE 1800 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF MINNESOTA | $3K | — | $3K | 1.49% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 901 MARQUETTE AVE., STE 1800 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $4K | — | $4K | 6.86% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 901 MARQUETTE AVE., STE 1800 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $2K | — | $2K | 3.13% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN RD - STE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $189 | — | $189 | 0.35% |
| MARC A GROVE3 Filed as: MARC GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | — | $10K | 23.36% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SERVICES, INC. | 80 SOUTH 8TH STREET - STE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 13.30% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS, LLC | 2000 CHAPEL VIEW BLVD - STE 240 CRANSTON, RI 02920 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $629 | $629 | 1.54% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVICES INC | PO BOX 749140 ATLANTA, GA 30374 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $336 | $336 | 0.82% |
| BENEFIT COMMUNICATIONS INC3 | 1 BURTON HILLS BLVD - STE 300E NASHVILLE, TN 37215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $146 | — | $146 | 0.36% |
| CHRISTOPHER THOMAS SMITH3 Filed as: CHRISTOPHER ROBERT MORRIS | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| BENEFIT COMMUNICATIONS INC3 | 1 BURTON HILLS BLVD-STE 300E NASHVILLE, TN 37215 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $128 | — | $128 | 4.17% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SERVICES, INC | 80 SOUTH 8TH STREET - STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $63 | — | $63 | 2.05% |
| CHRISTOPHER THOMAS SMITH3 Filed as: CHRISTOPHER MORRIS | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | — | $10 | 0.33% |
| MARC A GROVE3 Filed as: MARC GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | — | $10 | 0.33% |
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 |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 0 | $220K |
| Vision | VISION SERVICE PLAN | 0 | $54K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 741 | $574K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 741 | $534K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 741 | $534K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 741 | $537K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 741 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.