| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JARRELL BLACK AND COMPANY, LLC3 Filed as: THE JARRELL GROUP | 87 CHASE DRIVE HURRICANE, WV 25526 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 8.95% |
| LINDA S SHINN3 | 317 CHURCH ST PADEN CITY, WV 26159 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $555 | $329 | $884 | 8.90% |
| JARRELL BLACK AND COMPANY, LLC3 Filed as: THE JARRELL GROUP | 87 CHASE DRIVE HURRICANE, WV 25526 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $541 | — | $541 | 5.44% |
| MOUNTAIN STATE EMPLOYEE BENEFITS3 Filed as: MOUNTAIN STATE EMPLOYEE BENEFITS LL | 103 6TH AVENUE ST ALBANS, WV 25177 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $507 | — | $507 | 5.10% |
| CLAIMLINX, LLC3 | 10260 ALLIANCE ROAD SUITE 130 CINCINNATI, OH 45242 | HIGHMARK, WEST VIRGINIA, INC. | — | — | $0 | — |
| CLAIMLINX, LLC3 | 10260 ALLIANCE ROAD SUITE 130 CINCINNATI, OH 45242 | HUMANA, INC. | — | — | $0 | — |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HIGHMARK, WEST VIRGINIA, INC. | 0 | $0 |
| Dental | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY | 165 | $53K |
| Life insurance | STANDARD INSURANCE COMPANY | 197 | $17K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 16 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.