| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $31 | $4K | 12.63% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $660 | $2K | 7.41% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $493 | $493 | 1.54% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.01% |
| THOMAS J. MCCORD3 Filed as: THOMAS H GORRELL | 99 CAMBRIDGE PL BRIDGEPORT, WV 26330 | NORTHWESTERN MUTUAL | $2K | $442 | $2K | 7.78% |
| ADAM MICHAEL ROWH3 | 99 CAMBRIDGE PL BRIDGEPORT, WV 26330 | NORTHWESTERN MUTUAL | $2K | $442 | $2K | 7.78% |
| WHR AGENCY INC3 | 601 TENNESSEE AVE CHARLESTON, WV 25302 | NORTHWESTERN MUTUAL | $526 | $63 | $589 | 2.09% |
| ADAM MICHAEL ROWH3 | 99 CAMBRIDGE PL BRIDGEPORT, WV 26330 | NORTHWESTERN MUTUAL | $175 | $63 | $238 | 0.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFITS ADMINISTRATORS EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | 1975 TAMARACK RD NEWARK, OH 43055 | $34K |
| MEDICAL BENEFITS MUTUAL LIFE INS CO EIN 31-4210910 CONTRACT | Plan Administrator Service code 14 | 1975 TAMARACK RD NEWARK, OH 43055 | $8K |
| 4-MOST HOLDING, LLC EIN 31-1538612 CONTRACT | Other fees Service code 99 | P.O. BOX 741654 ATLANTA, GA 30384 | $7K |
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 | 95 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 95 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $32K |
| Long-term disability | NORTHWESTERN MUTUAL | 115 | $28K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE & HEALTH INSURANCE COMPANY | 99 | $242K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.