No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | P.O. BOX 1449 GOODLETTSVILLE, TN 37070 | $223K |
| WITHERS BENEFIT CONSULTANTS EIN 59-3309390 CONSULTANT | Consulting (general); Direct payment from the plan Service code 16 | P.O. BOX 9 SAN ANTONIO, FL 33576 | $30K |
| VENABLE LAW FIRM P.A. EIN 59-1824867 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 7402 N. 56TH STREET STE 380 TAMPA, FL 33617 | $26K |
| HORIZON ACTUARIAL SERVICES EIN 26-1370698 ACTUARIAL | Direct payment from the plan; Actuarial Service code 11 | 900 ASHWOOD PKWY STE 170 ATLANTA, GA 30338 | $12K |
| STEVEN D. EISENBERG CPA,PA EIN 65-0140643 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | 13790 NW 4TH STREET STE 100 SUNRISE, FL 33328 | $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 | 670 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 684 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 0 | $208K |
| Vision | VISION SERVICE PLAN | 667 | $46K |
| Life insurance | 5 STAR LIFE INSURANCE CO | 0 | $19K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 0 | $168K |
| Other | 5 STAR LIFE INSURANCE CO | 0 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 667 | — |
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.