| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $754 | $5K | 15.37% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $437 | $2K | 7.04% |
| ADAM MICHAEL ROWH3 | 99 CAMBRIDGE PL BRIDGEPORT, WV 26330 | NORTHWESTERN MUTUAL | $1K | $360 | $2K | 6.69% |
| THOMAS J. MCCORD3 Filed as: THOMAS H GORRELL | 99 CAMBRIDGE PL BRIDGEPORT, WV 26330 | NORTHWESTERN MUTUAL | $1K | $360 | $2K | 6.69% |
| WHR AGENCY INC3 | 601 TENNESSEE AVE CHARLESTON, WV 25302 | NORTHWESTERN MUTUAL | $429 | $51 | $480 | 1.79% |
| ADAM MICHAEL ROWH3 | 99 CAMBRIDGE PL BRIDGEPORT, WV 26330 | NORTHWESTERN MUTUAL | $143 | $51 | $194 | 0.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFITS ADMINISTRATORS EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | 1975 TAMARACK RD NEWARK, OH 43055 | $38K |
| MEDICAL BENEFITS MUTUAL LIFE INS CO EIN 31-4210910 CONTRACT | Plan Administrator Service code 14 | 1975 TAMARACK RD NEWARK, OH 43055 | $10K |
| 4-MOST HOLDING, LLC EIN 31-1538612 CONTRACT | Other fees Service code 99 | P.O. BOX 741654 ATLANTA, GA 30384 | $7K |
| MCM SOLUTIONS EIN 36-3445315 CONTRACT | Other fees Service code 99 | 23048 N 15TH AVE PHOENIX, AZ 85027 | $3K |
| AMERICAN HEALTH HOLDING INC. EIN 31-1368946 CONTRACT | Other fees Service code 99 | 7400 WEST CAMPUS ROAD F-510 NEW ALBANY, OH 43054 | $2K |
| PAYER COMPASS EIN 46-2047081 CONTRACT | Other fees Service code 99 | 5800 GRANITE PARKWAY SUITE 450 PLANO, TX 75024 | $411 |
| PRIVATE HEALTHCARE SYSTEMS EIN 04-3138814 CONTRACT | Other fees Service code 99 | 535 E DIEHL ROAD NAPERVILLE, IL 60563 | $70 |
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 | 103 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 200 | $33K |
| Long-term disability | NORTHWESTERN MUTUAL | 122 | $27K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE & HEALTH INSURANCE COMPANY | 100 | $250K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 200 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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."
No prospect flags tripped on this filing.