| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | PO BOX 1490 JACKSON, ME 39215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $88K | $21K | $110K | 18.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX/EVERETT A DIVISION OF HUB INTER | 300 CONCOURSE BOULEVARD RIDGELAND, MS 39157 | HCC LIFE INS CO. | $76K | — | $76K | 13.13% |
| THE BOTTRELL INSURANCE AGENCY3 Filed as: BOTTRELL INSURANCE AGENCY | POST OFFICE BOX 1490 JACKSON, MS 392151490 | HCC LIFE INS CO. | $38K | — | $38K | 6.56% |
| J MICHAEL NORRIS INC3 | 731 AVIGNON DRIVE RIDGELAND, MS 39157 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $1K | $9K | 1.95% |
| BARBARA L NEWTON3 | 142 STATE STREET PORTSMOUTH, NH 03801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $340 | $49 | $389 | 0.09% |
| DEIRDRE B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $244 | $36 | $280 | 0.06% |
| PROFESSIONAL BENEFITS CONSULTANTS I3 | PO BOX 12612 ALEXANDRIA, LA 71303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | $82 | $201 | 0.05% |
| EMMA ANN DEAN3 | 350 SOUTH BELVEDERE DRIVE HAMPSYEAD, NC 28443 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | $7 | $131 | 0.03% |
| MORRIS POWELL3 | 5002 BLUE GRASS COURT WILMINGTON, NC 28443 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | $7 | $131 | 0.03% |
| JAMES M EANES3 | 1700 EAST JACKSON STREET PENSACOLA, FL 32501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $42 | $117 | 0.03% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $11 | $60 | 0.01% |
| KIMBERLY FERGUSON3 | 4059 LOMAR DRIVE MOUNT AIRY, MD 21771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $23 | $58 | 0.01% |
| BRIAN WHITE3 Filed as: BRIAN R MADTES | 1308 JAMES COOK WINDCREST, TX 78239 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $18 | $52 | 0.01% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL OF NORTH TEXAS INSURANCE G | 4621 GLEN HEATHER DRIVE FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $22 | $44 | 0.01% |
| HEATHER LEA HOOTEN3 | 7111 NORTHEAST 222ND STREET MELROSE, FL 32666 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $19 | $37 | 0.01% |
| JAMES SNOW3 Filed as: JAMES G SNOW | 286 CASTLEGATE ROAD MACON, GA 31210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $1 | $31 | 0.01% |
| EDWARD CORRIVEAU3 | PO BOX 180 CENTER BARNSTEAD, NH 03225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.01% |
| COACH CONCEPTS INC3 | 9500 KOGER BOULEVARD ST PETERSBURG, FL 33702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $4 | $25 | 0.01% |
| WILLIAM RENNARD3 | 3001 ALOMA AVENUE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $9 | $22 | 0.00% |
| HAROLD J DOYLE3 | 892 RIDERS WAY EAST EVANS, GA 30809 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.00% |
| JOAN C KROEHLER3 | 35 3RD STREET BANGOR, ME 04401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.00% |
| ETHAN EXELBERT3 | 64 4TH AVENUE BROOKLYN, NY 11217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.00% |
| JERRY FORBIS3 Filed as: JERRY FORBIS JUNIOR | PO BOX 1025 PIKEVILLE, NC 27863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $8 | $14 | 0.00% |
| HOWARD HOROWITZ3 Filed as: HOWARD P DILEMA | 55 BROADWAY NEW YORK, NY 10006 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $9 | $11 | 0.00% |
| KID INSURANCE BENEFITS INC3 | 8045 ROYAL SAINT GEORGES LANE DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | 0.00% |
| PNC FINANCIAL ENTERPRISES INC3 | 1841 NORTH SHERRY DRIVE ATLANTIC BEACH, FL 32233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| JOHN D EVANGELISTA3 | 29811 SANTA MARGARITA PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.00% |
| SHARON L ROBERGE3 | 6 STONE STREET SACO, ME 04072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| ROBERT E PAGANI3 | 10840 SUNSET HILLS DRIVE RICHMOND, VA 23236 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| GAIL STEWART GOLD3 | 11919 SUNFLOWER LANE RICHMOND, VA 23236 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| TERRY J SILVERS3 Filed as: TERRY D GARRETT | 459 RUNNING FOX ROAD WEST COLUMBIA, SC 29223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| KJELL T TERRELL3 | 327 GOLF COURSE DRIVE RALEIGH, NC 27610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | PO BOX 1490 JACKSON, MS 39215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $67K | $21K | $88K | 19.77% |
| HARDY, ALLEN D3 | 802 KOSCIUSKO ROAD PHILADELPHIA, MS 39350 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 2.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | PO BOX 1490 JACKSON, MS 39215 | NATIONAL GUARDIAN LIFE | $18K | — | $18K | 10.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: FOX-EVERETT, INC. | 300 CONCOURSE BLVD SUITE 300 RIDGELAND, MS 39157 | NATIONAL GUARDIAN LIFE | $1K | — | $1K | 0.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 6650 METAIRE, LA 70009 | NATIONAL GUARDIAN LIFE | $113 | — | $113 | 0.07% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | PO BOX 1490 JACKSON, MS 39215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $7K | $21K | 22.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FISHER BROWN BOTTRELL INSURANCE INC | PO BOX 1490 JACKSON, MS 39215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $214 | $20 | $234 | 3.69% |
| ALLEN HARDY3 | PO BOX 89 PHILADELPHIA, MS 38350 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 2.16% |
| THOMAS E GRAHAM3 | PO BOX 501 OCEAN SPRINGS, MS 39566 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 2.16% |
| ROBBINS RESEARCH AND PLANNING INC3 | 731 AVIGNON DRIVE RIDGELAND, MS 39157 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $16 | $91 | 1.44% |
| HOLLINGSWORTH BENEFITS SOLUTIONS3 | 2 WIGEON RAYMOND, ME 39154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | $6 | $89 | 1.40% |
| REBECCA LYNN SMITH3 | 103 GRANFIELD COURT CANTON, MS 39046 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $5 | $42 | 0.66% |
| SEHC BENEFITS LLC3 Filed as: SEHC BEENFITS LLC | 242 SAWBRIDGE DRIVE RIDGELAND, MS 39157 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $10 | $31 | 0.49% |
| ADRIENNE HAMBY3 | 625 LEXINGTON COVE BYRAM, MS 39272 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.44% |
| J MICHAEL NORRIS INC3 | 731 AVIGNON DRIVE RIDGELAND, MS 39157 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $3 | $25 | 0.39% |
| SANTE CONCEPTS INC3 | PO BOX 723533 ATLANTA, GA 31139 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.32% |
| CHALSEE CANTRELL3 | 1007 THISTLE DRIVE MESQUITE, TX 75149 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $3 | $16 | 0.25% |
| THOMAS A TURNER IV INSURANCE LLC3 | 909 BAY RIDGE DRIVE JACKSON, MS 39211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.24% |
| VINSON K ELLENBERG3 | 905 ADAIR AVENUE NORTHEAST ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $1 | $9 | 0.14% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL OF NORTH TEXAS INSURANCE G | 4621 GLEN HEATHER DRIVE FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.03% |
| STEVEN WELTON GREGORY3 | 614 CAMELLIA POINTE BOULEVARD OCEAN SPRINGS, MS 39564 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.03% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES MICHAEL EMIDY | PO BOX 2021 RIDGELAND, MS 39158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.03% |
| SANDY DRIVER3 | 1703 TAMARACK DRIVE WYLIE, TX 75098 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| STACEY DIANE QUANCE3 | 5682 RIVER OAKS PLACE ATLANTA, GA 30327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| COBERN DEES HINTON3 | 2738 HIGHWAY 471 BRANDON, MS 39047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| TULLY AND COMPANY INC3 | 1926 STONE LANE MARIETTA, GA 30064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FOX/EVERETT, INC. EIN 64-0691633 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 300 CONCOURSE BLVD., SUITE 300 POST OFFICE BOX 6006 RIDGELAND, MS 391586006 | $220K |
| BOTRELL INSURANCE AGENCY BROKER | Custodial (securities) Service code 19 | PO BOX 1490 JACKSON, MS 39215 | $14K |
| PHILADELPHIA INSURANCE CO BROKER | Custodial (securities) Service code 19 | 528 E. MAIN STREET PHILADELPHIA, MS 39350 | $11K |
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 | 883 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 919 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE | 1,285 | $164K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,187 | $91K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 724 | $445K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,022 | $256K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INS CO. | 1,029 | $576K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,187 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,285 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.