| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP SECURITIES INC | ATTN CONNIE WINDORPSKI 1250 CAP. OF TX HWY S, BLDG 2 600 AUSTIN, TX 78746 | MINNESOTA LIFE INSURANCE COMPANY | $48K | — | $48K | 4.92% |
| AXA ASSISTANCE, USA3 Filed as: AXA NETWORK LLC | 4135 NORTH FRONT ST HARRISBURG, PA 17110 | MINNESOTA LIFE INSURANCE COMPANY | $3K | — | $3K | 0.33% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNCILMAN MICHAELS AND DOWNS | 555 FAIRMOUNT AVE BALTIMORE, MD 21286 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.47% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNCILMAN MICHAELS AND DOWNS | 555 FAIRMOUNT AVE BALTIMORE, MD 21286 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $6K | $10K | 12.27% |
| CHARLES D. BLOCK3 | UNIT 208 648 VILLAGE PARK DR. WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.08% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNCILMAN MICHAELS AND DOWNS | 555 FAIRMOUNT AVE BALTIMORE, MD 21286 | FIRST UNUM LIFE INSURANCE COMPANY | $188 | — | $188 | 5.65% |
| CHARLES D. BLOCK3 | UNIT 208 648 VILLAGE PARK DR. WILMINGTON, NC 28405 | FIRST UNUM LIFE INSURANCE COMPANY | $42 | — | $42 | 1.26% |
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 |
|---|---|---|---|
| Life insurance(5 contracts, 4 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 0 | $1.4M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.