| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BOTTRELL INSURANCE AGENCY3 | 248 E CAPITOL STREET SUITE 1200 PO BOX 1490 JACKSON, MS 39215 | STARMOUNT LIFE INSURANCE COMPANY | $16K | $2K | $18K | 12.49% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | 248 E CAPITOL STREET SUITE 1200 JACKSON, MS 39201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $5K | $16K | 17.77% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | 248 E CAPITOL STREET SUITE 1200 JACKSON, MS 39201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 13.51% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $833 | — | $833 | 1.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | 248 E CAPITOL STREET SUITE 1200 JACKSON, MS 39201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 17.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.83% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $945 | $945 | 2.55% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | 248 E CAPITOL STREET SUITE 1200 JACKSON, MS 39201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 17.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $821 | — | $821 | 2.65% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $769 | $769 | 2.48% |
| JOEL T. ALLEN4 | 544 PAWNEE WAY MADISON, MS 39110 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $307 | — | $307 | 4.99% |
| TIM C. LEWIS4 | 218 VALLEY RIDGE DRIVE JACKSON, MS 39206 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $55 | — | $55 | 0.89% |
| KEITH E. SMITH4 | 4481 CUMMINGS DRIVE CHATTANOOGA, TN 37419 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $31 | — | $31 | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FOX EVERETT A DIVSION OF HUB INTER EIN 35-0672425 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $50K |
| BOTTRELL EIN 64-0887176 BROKER | Custodial (securities) Service code 19 | — | $33K |
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 | 318 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 38 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 299 | $146K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 299 | $146K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 402 | $137K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $68K |
| Stop-loss / reinsurancereinsurance | SIRIUSPOINT AMERICA INSURANCE COMPANY | 334 | $582K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 402 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 402 | — |
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.