| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARMON DENNIS BRADSHAW INC3 Filed as: HARMON DENNIS BRADSHAW | 2 PERIMITER PARK SOUTH SUITE 450 WEST BIRMINGHAM, AL 35243 | PAN-AM LIFE INS CO | $30K | — | $30K | 12.65% |
| LAKESHORE BENEFIT ALLIANCE LLC3 Filed as: LAKESHORE BENEFIT ALLIANCE | 700 37TH ST S BIRMINGHAM, AL 35243 | PAN-AM LIFE INS CO | $14K | — | $14K | 5.83% |
| ACI3 | PO BOX 4000 COLLEGEVILLE, PA 19426 | PAN-AM LIFE INS CO | $13K | — | $13K | 5.39% |
| SURETY MARKETING3 Filed as: SURETY MARKETING SERVICES | 246 RIVER OAK DR MT PLEASANT, SC 28464 | PAN-AM LIFE INS CO | $12K | — | $12K | 4.86% |
| LBA SERVICE LLC3 Filed as: LBA SERVICE | 700 37TH ST S BIRMINGHAM, AL 35222 | PAN-AM LIFE INS CO | $2K | — | $2K | 0.97% |
| HARMON DENNIS BRADSHAW INC3 | PO BOX 241667 MONTGOMERY, AL 36124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 4.00% |
| DAVID MARKS3 Filed as: DAVID REEVES | 10524 CLAYBROOK DR BATON ROUGE, LA 70809 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.87% |
| LEWIS BROCK3 | 8776 SPRING GRV N MOBILE, AL 36695 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $98 | $1K | 1.48% |
| SUSAN J GOODSPEED3 Filed as: SUSAN GOODSPEED | 2866 BROOKSIDE DR MOBILE, AL 36693 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $743 | — | $743 | 0.95% |
| KATHRYN KENNER DECOUX3 Filed as: KATHRYN DECOUX | 2210 SPRINGWOOD DR AUBURN, AL 36830 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $640 | — | $640 | 0.82% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $337 | — | $337 | 0.43% |
| KATHLEEN FERRELLI3 | 3547 SHANNON VILLAGE RD COOKEVILLE, TN 38506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $281 | — | $281 | 0.36% |
| JOSEPH ARTHUR CINK3 Filed as: JOSEPH CINK | 19460 STATE HIGHWAY 181 FAIRHOPE, AL 36532 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $281 | — | $281 | 0.36% |
| SHIRLEY KING3 | 625 INDUSTRIAL PARK RD CULLMAN, AL 35055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $149 | — | $149 | 0.19% |
| JENNIFER CUSHMAN3 | 5038 CAMELOT DR W MOBILE, AL 36619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $122 | $147 | 0.19% |
| MELISSA BILLINGSLEY3 | 3224 OAKLEIGH CIRCLE OCEAN SPRINGS, MS 39564 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $17 | $75 | 0.10% |
| SHERREL S COCHRAN3 Filed as: SHERREL COCHRAN | 3734 BRANCH DR SEMMES, AL 36575 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.07% |
| CAROLYN D DINKINS3 Filed as: CAROLYN DINKINS | PO BOX 180125 MOBILE, AL 36618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| HEATHER HORN3 | 126 REED LN LOCUST FORK, AL 35097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $3 | $11 | 0.01% |
| DAVID TYLER BURRUS3 Filed as: DAVID BURRUS | 143 MERRELL DR SHELBY, AL 35143 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | $1 | $1 | 0.00% |
| HARMON DENNIS BRADSHAW INC3 | PO BOX 241667 MONTGOMERY, AL 36124 | STARMOUNT LIFE INSURANCE COMPANY | $1K | — | $1K | 11.88% |
| HARMON DENNIS BRADSHAW INC3 | 2 PERIMITER PARK SOUTH SUITE 450 WEST BIRMINGHAM, AL 35243 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $746 | — | $746 | 10.07% |
| HARMON DENNIS BRADSHAW INC3 | 4131 CARMICHAEL ROAD MONTGOMERY, AL 36106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $729 | — | $729 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF ALABAMA EIN 63-0103830 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 450 RIVERCHASE PARKWAY EAST BIRMINGHAM, AL 35298 | $3K |
| WAGEWORKS INC EIN 94-3351864 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 4609 REGENT BLVD IRVING, TX 75063 | $3K |
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 | 165 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF ALABAMA | 186 | $1.3M |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 16 | $7K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 100 | $11K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 97 | $78K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 97 | $78K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 25 | $5K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF ALABAMA | 186 | $1.1M |
| Other | BLUE CROSS & BLUE SHIELD OF ALABAMA | 186 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.