| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NELSON INSURANCE CONSULTING | 1143 SHIPWATCH CIRCLE TAMPA, FL 33602 | HCC LIFE INSURANCE COMPANY | $5K | — | $5K | 6.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Contract Administrator Service code 13 | — | $259K |
| CAREFIRST EIN 52-1330940 NONE | Claims processing Service code 12 | — | $79K |
| O'DONOGHUE & O'DONOGHUE EIN 53-0210528 NONE | Legal Service code 29 | — | $18K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 NONE | Other services Service code 49 | — | $14K |
| SALTER & COMPANY LLC EIN 20-8078757 NONE | Accounting (including auditing) Service code 10 | — | $11K |
| AMALGAMATED BANK EIN 13-4920330 CUST/INV MGR | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $10K |
| BOLTON PARTNERS EIN 52-1231144 NONE | Actuarial Service code 11 | — | $9K |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 165 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 411 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 413 | $52K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 273 | $73K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 413 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 413 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.