| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SYMETRA LIFE INSURANCE COMPANY | — | $14K | $14K | 4.25% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $646 | — | $646 | 11.58% |
| BCINSOURCING, LLC3 Filed as: BCINSOURCING LLC | 6363 COLLEGE BOULEVARD, SUITE 500 OVERLAND PARK, KS 66211 | CONTINENTAL AMERICAN INSURANCE COMPANY | $619 | — | $619 | 11.10% |
| LESLIE TENNILLE CUMPTAN3 | 801 CARR AVENUE HOMEWOOD, AL 35209 | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | — | $56 | 1.00% |
| BRANDON L MILLER3 Filed as: BRANDON LEE MILLER | 5852 EMPIRE MILLS RUN CANAL WINCHESTER, OH 43110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.48% |
| ZACHARY DUNHAM3 Filed as: ZACHARY JAMES DUNHAM | 117 DEER VALLEY DRIVE HURRICANE, WV 25526 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.30% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BLUE CROSS BLUE SHIELD WV EIN 55-0624615 ADMINISTRATOR | Contract Administrator Service code 13 | — | $174K |
| DELTA DENTAL OF WEST VIRGINIA EIN 55-0523124 ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| RXBENEFITS, INC. EIN 63-1157085 ADMINISTRATOR | Contract Administrator Service code 13 | — | $6K |
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 | 269 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 230 | $57K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 261 | $335K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 19 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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.