| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| P & C RISK SERVICES LLC D.B.A ATHEN Filed as: P&C RISK SERVICES LLC | DBA ATHENS INSURANCE AGENCY 110 WEST WASHINGTON AVENUE NW ATHENS, TN 37371 | DEARBORN NATIONAL | $6K | — | $6K | 5.88% |
| P & C RISK SERVICES LLC D.B.A ATHEN Filed as: P&C RISK SERVICES LLC | DBA ATHENS INSURANCE AGENCY 110 WEST WASHINGTON AVE ATHENS, TN 37371 | TOKIO MARINE | $3K | $0 | $3K | 5.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSCOPE BENEFITS EIN 71-0847266 | Contract Administrator Service code 13 | 27 CORPORATE HILL DRIVE LITTLE ROCK, AR 72205 | $42K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 115 W WAUSAU AVE WAUSAU, WI 54401 | $19K |
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 | 98 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | DEARBORN NATIONAL | 106 | $158K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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.