| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3716 NORFOLK, VA 23514 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $3K | $8K | 2.12% |
| ENROLLMENT RESOURCES GROUP3 Filed as: ENROLLMENT ADVISORS, INC. | 120 18TH STREET SOUTH, SUITE 102 BIRMINGHAM, AL 35233 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 5.54% |
| LANIER UPSHAW, INC.3 | 1115 US 98 SOUTH LAKELAND, FL 33801 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.91% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVENUE EAST SUITE 1500 CLEVELAND, OH 44114 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $190 | — | $190 | 0.16% |
| ASSUREX3 | 175 SOUTH 3RD STREET, SUITE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1 | $1 | 0.00% |
| ENROLLMENT RESOURCES GROUP3 Filed as: ENROLLMENT ADVISORS, INC. | 120 18TH STREET SOUTH, SUITE 102 BIRMINGHAM, AL 35233 | FIRST UNUM LIFE INSURANCE COMPANY | $69 | — | $69 | 4.79% |
| LANIER UPSHAW, INC.3 | 1115 US 98 SOUTH LAKELAND, FL 33801 | FIRST UNUM LIFE INSURANCE COMPANY | $10 | — | $10 | 0.69% |
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 | 1,289 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,573 | $489K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,573 | $372K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,573 | $489K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,573 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.