| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSS & YERGER INSURANCE INC3 Filed as: ROSS AND YERGER INSURANCE INC | P O BOX 1139 JACKSON, MS 39215 | BLUE CROSS BLUE SHIELD OF MISSISSIPPI | $4K | — | $4K | 1.58% |
| CORPORATE BENEFITS INC3 | P O BOX 1489 MADISON, MS 39130 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 6.43% |
| ROSS & YERGER INSURANCE INC3 Filed as: ROSS AND YERGER INSURANCE INC | P O BOX 1139 JACKSON, MS 39215 | STARMOUNT LIFE INSURANCE COMPANY | $219 | — | $219 | 4.41% |
| CORPORATE BENEFITS INC3 | P O BOX 1489 MADISON, MS 39130 | STARMOUNT LIFE INSURANCE COMPANY | $129 | — | $129 | 2.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MS EIN 64-0295748 CLAIMS ADMIN | Contract Administrator; Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $81K |
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 | 382 | 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) | 382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MISSISSIPPI | 269 | $274K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 382 | $78K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 382 | $73K |
| Other | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 382 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 382 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.