| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VALENT GROUP3 Filed as: VALENT GROUP LLC | 3500 BLUE LAKE DRIVE, SUITE 120 BIRMINGHAM, AL 35243 | HARTFORD LIFE AND ACCIDENT | $7K | $411 | $8K | 15.54% |
| S S NESBITT & CO INC3 Filed as: SS NESBITT & CO. | 3500 BLUE LAKE DRIVE, SUITE 120 BIRMINGHAM, AL 35243 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $796 | $0 | $796 | 10.03% |
| J R PREWITT & ASSOCIATES INC3 | PO BOX 55088 BIRMINGHAM, AL 35255 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $143 | $0 | $143 | 6.79% |
| USI INSURANCE SERVICES LLC3 | 1100 URBAN CENTER DRIVE BIRMINGHAM, AL 35242 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 1.00% |
| VALENT GROUP3 Filed as: VALENT GROUP LLC | 3500 BLUE LAKE DRIVE, SUITE 120 BIRMINGHAM, AL 35243 | MDLILVE | $281 | $0 | $281 | 15.54% |
No Schedule C service providers reported on this filing.
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 125 | $503K |
| Dental | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 125 | $503K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 109 | $8K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 100 | $51K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 100 | $51K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 100 | $51K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 125 | $503K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 100 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.