| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS C SMITH3 Filed as: THOMAS C. SMITH | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | ALLSTATE (AMERICAN HERITAGE LIFE) | $3K | — | $3K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF VIRGINIA INC | 4951 LAKE BROOK DR SUITE 300 GLEN ALLEN, VA 23060 | ALLSTATE (AMERICAN HERITAGE LIFE) | $2K | — | $2K | 4.00% |
| MCCULLUGH, CHRISTINE M3 | 14715 NE 95TH STREET SUITE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.00% |
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 | 1,572 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,602 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ALLSTATE (AMERICAN HERITAGE LIFE) | 83 | $56K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 2,658 | $98K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,286 | $175K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,390 | $433K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,390 | $433K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,286 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,658 | — |
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.