| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFIT SERVICES, INC.5 Filed as: AMERICAN BENEFIT CORPORATION | 3150 U S ROUTE 60 ONA, WV 25545 | UNION LABOR LIFE INSURANCE COMPANY | $20K | — | $20K | — |
| EASTWOOD CONSULTANTS5 Filed as: EASTWOOD CONSULTING | 3150 ROUTE 60 ONA, WV 25545 | UNION LABOR LIFE INSURANCE COMPANY | $10K | — | $10K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERICAN BENEFIT CORPORATION EIN 55-0672859 NONE | Direct payment from the plan; Other fees; Claims processing Service code 12 | 3150 U. S. ROUTE 60 ONA, WV 25545 | $207K |
| ANTHEM HEALTH PLANS EIN 06-1475928 NONE | Other fees; Direct payment from the plan Service code 50 | 4361 IRWIN SIMPSON ROAD MASON, OH 45040 | $58K |
| HARRIS, HARDIN & COMPANY, A.C. EIN 55-0756523 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 404 NINTH STREET HUNTINGTON, WV 25701 | $12K |
| STANDARD VALUATIONS EIN 41-1329739 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | 790 CLEVELAND AVENUE, S ST. PAUL, MN 55116 | $10K |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 156 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 128 | $0 |
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 169 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.