| 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 AMERICAN INS COMP | $13K | — | $13K | 12.66% |
| LAKESHORE BENEFIT ALLIANCE LLC3 Filed as: LAKESHORE BENEFIT ALLIANCE | 700 37TH ST S BIRMINGHAM, AL 35222 | PAN AMERICAN INS COMP | $6K | — | $6K | 5.84% |
| SURETY MARKETING3 | 246 RIVER OAK DR MT PLEASANT, SC 28464 | PAN AMERICAN INS COMP | $5K | — | $5K | 4.87% |
| LBA SERVICE LLC3 Filed as: LBA SERVICE | 700 37TH ST S BIRMINGHAM, AL 35222 | PAN AMERICAN INS COMP | $991 | — | $991 | 0.97% |
| HARMON DENNIS BRADSHAW INC3 | PO BOX 241667 MONTGOMERY, AL 36124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1 | $2K | 2.11% |
| DAVID MARKS3 Filed as: DAVID REEVES | 10524 CLAYBROOK DR BATON ROUGE, LA 70809 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.75% |
| ESTATE OF DAVID GLENN REEVES3 | 10524 CLAYBROOK DR BATON ROUGE, LA 70809 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.66% |
| SUSAN J GOODSPEED3 Filed as: SUSAN GOODSPEED | 2866 BROOKSIDE DR MOBILE, AL 36693 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.48% |
| LEWIS BROCK3 | 8776 SPRING GRV N MOBILE, AL 36695 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $90 | $1K | 1.45% |
| JOSEPH ARTHUR CINK3 Filed as: JOSEPH CINK | 19460 STATE HWY 181 FAIRHOPE, AL 36532 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.29% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HWY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $420 | — | $420 | 0.48% |
| MELISSA BILLINGSLEY3 | 1509 GOVERNMENT ST FI 4 MOBILE, AL 36604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $143 | $228 | 0.26% |
| KATHLEEN FERRELLI3 | 3547 SHANNON VILLAGE RD COOKEVILLE, TN 38506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $227 | — | $227 | 0.26% |
| SHIRLEY KING3 | 625 INDUSTRIAL PARK RD CULLMAN, AL 35055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | — | $154 | 0.17% |
| SHERREL S COCHRAN3 Filed as: SHERREL COCHRAN | 3734 BRANCH DR SEMMES, AL 36575 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 0.08% |
| CAROLYN DINKINS | PO BOX 180125 MOBILE, AL 36618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.02% |
| KATHRYN KENNER DECOUX3 Filed as: KATHRYN DECOUX | 2210 SPRINGWOOD DR AUBURN, AL 36830 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| HARMON DENNIS BRADSHAW INC3 | 4131 CARMICHAEL ROAD MONTGOMERY, AL 36106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $849 | — | $849 | 15.00% |
| HARMON DENNIS BRADSHAW INC3 | PO BOX 241667 MONTGOMERY, AL 36124 | STARMOUNT LIFE INSURANCE COMPANY | $238 | — | $238 | 8.37% |
| HARMON DENNIS BRADSHAW INC3 Filed as: HARMON DENNIS BRADSHAW | 2 PERIMITER PARK SOUTH SUITE 450 WEST BIRMINGHAM, AL 35243 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $188 | — | $188 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF ALABAMA EIN 63-0103830 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 450 RIVERCHASE PARKWAY EAST BIRMINGHAM, AL 35298 | $1K |
| WAGEWORKS INC EIN 94-3351864 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 4609 REGENT BLVD IRVING, TX 75063 | $999 |
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 | 173 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 173 | 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 | 190 | $352K |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 17 | $2K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 103 | $3K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 103 | $88K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 103 | $88K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 30 | $6K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF ALABAMA | 190 | $250K |
| Other | BLUE CROSS & BLUE SHIELD OF ALABAMA | 190 | $250K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.