| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DRIVE PO BOX 527 FARMINGTON, CT 06034 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $74K | $14K | $88K | 18.20% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $20K | $699 | $21K | 4.26% |
| LANDRY HARRIS & CO LLC3 Filed as: LANDRY HARRIS & CO., LLC | 600 JEFFERSON ST STE 200 LAFAYETTE, LA 70501 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 1.67% |
| TFC INSURANCE AGENCY INC3 | 30 WATERSIDE DRIVE PO BOX 527 FARMINGTON, CT 06034 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.57% |
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DRIVE PO BOX 527 FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $44K | $6K | $50K | 20.61% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $181 | $7K | 2.74% |
| LANDRY HARRIS & CO LLC3 Filed as: LANDRY HARRIS & CO., LLC | 600 JEFFERSON STREET STE 200 LAFAYETTE, LA 70501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.09% |
| BENEFITS SOLUTIONS GROUP LLC3 Filed as: BENEFITS SOLUTIONS GROUP INC | 8702 JEFFERSON HWY STE A BATON ROUGE, LA 70809 | SYMETRA LIFE INSURANCE COMPANY | $16K | — | $16K | 16.34% |
| UDB INSURANCE LLC3 | 205 ANSLEY BLVD SUITE A ALEXANDRIA, LA 71303 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF SC EIN 57-0287419 | Direct payment from the plan; Recordkeeping fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $586K |
| MARTCO LLC EIN 72-0920365 PLAN SPONSOR | Participant communication; Plan Administrator; Contract Administrator; Copying and duplicating; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing Service code 10 | — | $195K |
| ELLSWORTH CORPORATION | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $97K |
| SCRIPT CARE LTD EIN 76-0621375 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Claims processing; Direct payment from the plan Service code 12 | — | $60K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Recordkeeping fees; Direct payment from the plan Service code 12 | — | $52K |
| BENEFITS SOLUTION GROUP INC | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 8702 JEFFERSON HWY STE A BATON ROUGE, LA 70809 | $22K |
| TASC EIN 39-1561025 | Recordkeeping fees; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $19K |
| PAYNE MOORE AND HERRINGTON LLP EIN 72-0475011 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $14K |
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 | 1,109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 89 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 608 | $80K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | 1,468 | $581K |
| Short-term disability | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | 1,468 | $483K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,065 | $236K |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | 1,468 | $727K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,468 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.