No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFITS ADMINISTRATOR INC EIN 59-6154877 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 1449 GOODLETTSVILLE, TN 37070 | $118K |
| CONNECTICUT GENERAL LIFE INS CO EIN 06-0303370 CLAIMS PROCESSING | Claims processing Service code 12 | 5089 COLLECTION CENTER DR CHICAGO, IL 606930050 | $94K |
| MEDICAL EXCESS STOP LOSS INSURANCE | Trustee (individual) Service code 20 | P.O. BOX 842173 LOS ANGELES, CA 900842173 | $74K |
| THE SEGAL COMPANY EIN 13-1975125 CONSULTANT | Consulting (general) Service code 16 | 101 NORTH WACKER DRIVE CHICAGO, IL 606061724 | $41K |
| GRAMLING & HAYA, CPA'S, PA EIN 59-1891796 PLAN AUDITOR | Accounting (including auditing) Service code 10 | P.O. BOX 290069 TAMPA, FL 33687 | $17K |
| VENABLE LAW FIRM, PA EIN 59-1824867 PLAN ATTORNEY | Legal Service code 29 | 7402 N 56TH ST,SUITE 380 TAMPA, FL 33617 | $14K |
| EATON VANCE INVESTMENT MANAGEMENT | Investment management Service code 28 | 2 INTERNATIONAL PL,1400 617-482-8260 BOSTON, MA 02110 | $13K |
| SOUTHERN BENEFIT ADMINISTRATORS,INC EIN 59-6154877 PRINTING, POSTAGE, COPIES | Copying and duplicating; Other services Service code 36 | P.O. BOX 1449 GOODLETSVILLE, TN 370701449 | $10K |
| FOX ASSET MANAGEMENT, LLC INVESTMENT MANAGEMENT | Investment management Service code 28 | 331 NEWMAN SPRINGS RD,122 RED BANK, NJ 07701 | $3K |
| CIGNA BEHAVIORAL HEALTH CASE MANAGEMENT | Consulting (general) Service code 16 | 11095 VIKING DR 800-433-5768 EDEN PRAIRIE, MN 55344 | $2K |
| J. PAT WILLIAMS INSURANCE INSURANCE AGENT | Insurance agents and brokers Service code 22 | P.O. BOX 8247 CHATANOOGA, TN 37414 | $0 |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 179 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.