| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR SUITE 100 JOHNS CREEK, GA 30097 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 4.70% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 2.40% |
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON STREET SUITE 1200 CONSHOCKEN, PA 19428 | DELTA DENTAL OF KENTUCKY | $3K | — | $3K | 2.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $175K |
| MARSH & MCLENNAN AGENCY EIN 26-3237576 BROKER | Other commissions Service code 55 | 360 EAST VINE STREET LEXINGTON, KY 40507 | $7K |
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 | 340 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 633 | $156K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 449 | $263K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 449 | $263K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 281 | $408K |
| Other | HARTFORD LIFE AND ACCIDENT | 449 | $263K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 633 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.