| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GAIL FORSYTHE-FORSYTHE GROUP LLC3 | PO BOX 3743 CHARLESTON, WV 25337 | CITIZENS SECURITY LIFE INSURANCE COMPANY | $9K | $0 | $9K | 13.59% |
| PETERSON FINANCIAL INC3 Filed as: PETERSON FINANCIAL INC. | 605 BRADY AVE. STEUBENVILLE, OH 43952 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.81% |
| MUNDELL FINANCIAL GROUP3 | 69 CLAY STREET MORGANTOWN, WV 26501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.10% |
| CBF BENEFITS INC3 Filed as: CBF BENEFITS, INC. | 808 CEDAR AVE. PITTSBURGH, PA 15212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $29 | $1K | 2.47% |
| NORTHWEST WORKSITE MARKETING CORP3 Filed as: NORTHWEST WORKSITE MARKETING CORP. | 1910 INDIANWOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $61 | $1K | 2.39% |
| JAMES DANIEL MARTINETTE3 | 2001 DECATUR AVENUE WHEELING, WV 26003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $898 | $73 | $971 | 2.15% |
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 | 406 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $45K |
| Dental | CITIZENS SECURITY LIFE INSURANCE COMPANY | 242 | $69K |
| Vision | CITIZENS SECURITY LIFE INSURANCE COMPANY | 242 | $69K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $45K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $45K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $45K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.