| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MILLETTE ADMINISTRATORS, INC.3 Filed as: MILLETTE ADMINISTRATORS, INC | 4619 MAIN ST STE A MOSS POINT, MS 39563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MILLETTE ADMINISTRATORS EIN 42-0583743 NONE | Plan Administrator Service code 14 | 4619 MAIN STREET MOSS POINT, MS 39563 | $61K |
| ROBEIN, URANN, SPENCER, PICARD EIN 72-0999672 NONE | Legal Service code 29 | — | $31K |
| BETTY OTOO EIN 64-0364110 EE OF PLAN | Employee (plan sponsor) Service code 35 | 4619 MAIN STREET MOSS POINT, MS 39563 | $20K |
| THE KBA GROUP, PC EIN 63-1134001 NONE | Accounting (including auditing) Service code 10 | 720 EXECUTIVE PARK DRIVE MOBILE, AL 36606 | $17K |
| DUMMER LAW GROUP, PLLC EIN 46-4066516 NONE | Legal Service code 29 | 770 WATER STREET BILOXI, MS 39530 | $7K |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 209 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 377 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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.