| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GLENN H DONALD JR3 Filed as: GLENN H DONALD, JR | P.O. BOX 530464 BIRMINGHAM, AL 35253 | SOUTHLAND NATIONAL INSURANCE | $2K | — | $2K | 5.00% |
| LAKESHORE BENEFIT ALLIANCE LLC3 Filed as: LAKESHORE BENEFIT ALLIANCE | 700 37TH STREET SOUTH BIRMINGHAM, AL 35222 | SOUTHLAND NATIONAL INSURANCE | $2K | — | $2K | 5.00% |
| JUSTIN MICHAEL BANKS3 | 123 HILLTOP BUSINESS DRIVE PELHAM, AL 35124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $521 | $166 | $687 | 2.66% |
| JANICE BANKS3 | 123 HILLTOP BUSINESS DRIVE PELHAM, AL 35124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $273 | $5 | $278 | 1.08% |
| CHRIS BANKS3 | 123 HILLTOP BUSINESS DRIVE PELHAM, AL 35124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | $47 | $199 | 0.77% |
| ENID CHANDLER3 | 4736 W NAPOLEAN AVENUE METARIE, LA 70001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | — | $116 | 0.45% |
| LISA MARIE KLEIN3 | 1509 KINGS ROAD CANTONMENT, FL 32533 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 0.29% |
| D'ARCIPRETE & ASSOCIATES INC3 Filed as: D'ARCIPRETE & ASSOCIATES INC. | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | $9 | $68 | 0.26% |
| CAROLE H WARREN3 | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.20% |
| KRISTEN BIBLE3 | 4516 LATROBE COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.08% |
| JULIE S PERRY3 | 211 TURNBERRY STREET PORT WENTWORTH, GA 31407 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.07% |
| GLENN H DONALD JR3 | P.O. BOX 530464 BIRMINGHAM, AL 35253 | UNION SECURITY INSURANCE COMPANY | $764 | — | $764 | 7.50% |
| MURFEE MEADOWS INC3 Filed as: MURFEE MEADOWS INC. | 120 OFFICE PARK DRIVE STE 100 BIRMINGHAM, AL 35223 | UNION SECURITY INSURANCE COMPANY | $764 | — | $764 | 7.50% |
| GLENN H DONALD JR3 Filed as: GLENN H DONALD, JR. | P.O. BOX 530464 BIRMINGHAM, AL 35253 | NATIONAL GUARDIAN LIFE | $422 | — | $422 | 4.85% |
| LAKESHORE BENEFIT ALLIANCE LLC3 Filed as: LAKESHORE BENEFIT ALLIANCE | 700 37TH STREET SOUTH BIRMINGHAM, AL 35222 | NATIONAL GUARDIAN LIFE | $422 | — | $422 | 4.85% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 161 | $915K |
| Dental | SOUTHLAND NATIONAL INSURANCE | 140 | $30K |
| Vision | NATIONAL GUARDIAN LIFE | 134 | $9K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 21 | $26K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 21 | $26K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 11 | $10K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 161 | $915K |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 161 | $940K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.