| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| XS INSURANCE, INC.3 | 5252 HAMILTON RD COLUMBUS, GA 31904 | WESTPORT INSURANCE CORPORATION | $5K | — | $5K | 6.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 400 GALERIA PKWY SE SUITE 300 ATLANTA, GA 303393182 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $116 | $2K | 8.67% |
| NELSON INSURANCE CONSULTING3 Filed as: NELSON INS CONSULTING | 1143 SHIPWATCH CR. TAMPA, FL 33602 | 5STAR LIFE INSURANCE COMPANY | $2K | — | $2K | 100.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS INC EIN 62-1116095 NONE | Consulting (pension); Plan Administrator; Direct payment from the plan; Consulting (general) Service code 14 | — | $241K |
| CIGNA EIN 59-1031071 NONE | Named fiduciary; Other services; Contract Administrator; Participant communication; Float revenue; Non-monetary compensation; Direct payment from the plan; Claims processing Service code 12 | — | $196K |
| NEEDLES & ASSOCIATES LLC EIN 51-0435869 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $28K |
| GODWIN, MORRIS, LAURENZI & BLOOMFIE EIN 62-1371542 NONE | Legal; Direct payment from the plan Service code 29 | — | $15K |
| NEW SOUTH CAPITAL MANAGEMENT EIN 62-1237220 NONE | Direct payment from the plan; Investment management Service code 28 | — | $9K |
| REGIONS BANK EIN 62-1164500 NONE | Custodial (securities) Service code 19 | — | $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 | 574 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 135 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 709 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,494 | $26K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 602 | $76K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,494 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,494 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.