| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF NEW ENGLAND, LLC | 30 BRAINTREE HILL OFFICE PARK SUITE 203 BRAINTREE, MA 02184 | HCC LIFE INSURANCE COMPANY | $33K | — | $33K | 7.39% |
| H.J. KNIGHT INTERNATIONAL INSURANCE3 | 30 BRAINTREE HILL OFFICE PARK STE 203 BRAINTREE, MA 02184 | ULLICO | $4K | — | $4K | 4.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD EIN 54-0357120 NONE | Direct payment from the plan; Contract Administrator; Other services; Participant communication; Named fiduciary; Claims processing Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | $215K |
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Consulting (general); Plan Administrator; Actuarial Service code 11 | P.O. BOX 1449 GOODLETTSVILLE, TN 37070 | $206K |
| WILBANKS SMITH & THOMAS ASSET MGMT NONE | Investment management Service code 28 | 150 WEST MAIN ST STE 1700 800-229-3677 NORFOLK, VA 23510 | $29K |
| DANIELS, IRWIN & AYLOR EIN 62-1802605 NONE | Accounting (including auditing) Service code 10 | 223 MADISON ST. STE 112 MADISON, TN 37115 | $21K |
| SWIFTMD NONE | Other services; Claims processing Service code 12 | 801 SPRINGDALE DR 484-875-3085 EXTON, PA 19341 | $12K |
| BRANSTETTER STRANCH & JENNINGS EIN 62-0513048 NONE | Legal Service code 29 | 223 ROSA L. PARKS BLVD NASHVILE, TN 37203 | $9K |
| TRUIST BANK EIN 56-0939887 NONE | Custodial (other than securities) Service code 18 | 214 NORTH TRYON STREET CHARLOTTE, NC 28202 | $5K |
| MUTUAL & EXCHANGE TRADED FUNDS NONE | Custodial (securities); Investment management Service code 19 | — | $0 |
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 | 411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 118 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 529 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ULLICO | 529 | $85K |
| Prescription drug | HUMANA INSURANCE COMPANY | 118 | $495K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 529 | $442K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 529 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.