| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 | 1540 CORNERSTONE BLVD STE 230 DAYTONA BEACH, FL 321177144 | HUMANA HEALTH PLAN, INC. | $15K | — | $15K | 3.54% |
| FOUNDATION RISK PARTNERS CORP3 | 1540 CORNERSTONE BLVD STE 230 STE 230 DAYTONA BEACH, FL 321177144 | HUMANA HEALTH PLAN, INC. | $7K | — | $7K | 1.75% |
| FOUNDATION RISK PARTNERS CORP3 | 1540 CORNERSTONE BLVD STE 230 DAYTONA BEACH, FL 321177144 | ONEAMERICA | $25K | $3K | $28K | 16.17% |
| FOUNDATION RISK PARTNERS CORP3 | 1540 CORNERSTONE BLVD STE 230 DAYTONA BEACH, FL 321177144 | THE DENTAL CONCERN, INC. | $5K | $642 | $6K | 4.88% |
| FOUNDATION RISK PARTNERS CORP3 | 9700 ORNSBY STATION RD LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $141 | $4K | 7.92% |
| JAMES FINN3 | 8093 SAINT JOHNS RD FLOYDS KNOBS, IN 47119 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.34% |
| JEFFREY D HARNED3 | 13117 EASTPOINT PARK BLVD LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $880 | $842 | $2K | 3.24% |
| WILLIAM JACK MITCHELL JR3 | 920 S ASH ST NORTH PLATTE, NE 69101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $769 | $242 | $1K | 1.90% |
| LIG BENEFITS LLC3 | 11918 PERRY CROSSING PARKWAY SELLERSBURG, IN 47172 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.09% |
| RTR AL CORP3 | 100 PROMENADE COURT LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.08% |
| FOUNDATION RISK PARTNERS CORP3 | 1540 CORNERSTONE BLVD STE 230 STE 230 DAYTONA BEACH, FL 321177144 | THE DENTAL CONCERN, INC. | $252 | $549 | $801 | 4.04% |
| FOUNDATION RISK PARTNERS CORP3 | 9700 ORNSBY STATION ROAD LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $79 | $2K | 12.76% |
| JAMES FINN3 | 8093 SAINT JOHNS RD FLOYDS KNOBS, IN 47119 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 8.14% |
| JEFFREY D HARNED3 | 13117 EASTPOINT PARK BLVD LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $357 | $465 | $822 | 5.26% |
| WILLIAM JACK MITCHELL JR3 | 920 S ASH STREET NORTH PLATTE, NE 69101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $293 | $132 | $425 | 2.72% |
| LIG BENEFITS LLC3 | 11918 PERRY CROSSING PARKWAY SELLERSBURG, IN 47172 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| RTR AL CORP3 | 100 PROMENADE COURT LOUISVILLE, KY 40223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 NONE | Claims processing Service code 12 | — | $197K |
| FOUNDATION RISK PARTNERS EIN 81-5191759 NONE | Other commissions Service code 55 | 4634 GULFSTARR DR DESTIN, FL 32541 | $51K |
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HUMANA HEALTH PLAN, INC. | 207 | $817K |
| Dental(2 contracts) | THE DENTAL CONCERN, INC. | 179 | $134K |
| Vision(2 contracts) | THE DENTAL CONCERN, INC. | 179 | $134K |
| Life insurance | ONEAMERICA | 244 | $173K |
| Short-term disability | ONEAMERICA | 244 | $173K |
| Long-term disability | ONEAMERICA | 244 | $173K |
| Stop-loss / reinsurancereinsurance | SWISS RE-SWISS RE | 199 | $523K |
| Other | ONEAMERICA | 244 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.