| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JARRELL BLACK AND COMPANY, LLC3 Filed as: THE JARRELL GROUP | 45 CHASE DRIVE SUITE 2 HURRICANE, WV 25526 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 8.82% |
| CLAIMLINX, LLC3 | 10260 ALLIANCE ROAD SUITE 130 CINCINNATI, OH 45242 | HIGHMARK, WEST VIRGINIA, INC. | — | — | $0 | — |
| MOUNTAIN STATE EMPLOYEE BENEFITS3 Filed as: MOUNTAIN STATE EMPLOYEE BENEFITS LL | 103 6TH AVENUE ST ALBANS, WV 25177 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | — | $0 | — |
| LINDA S SHINN3 | 317 CHURCH ST PADEN CITY, WV 26159 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | — | $0 | — |
| JARRELL BLACK AND COMPANY, LLC3 Filed as: THE JARRELL GROUP | 87 CHASE DRIVE HURRICANE, WV 25526 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | — | $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 | 153 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 153 | 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 | 156 | $53K |
| Life insurance | STANDARD INSURANCE COMPANY | 196 | $18K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 0 | $0 |
| 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.