| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NELSEN INSURANCE CONSULTING INC3 Filed as: NELSEN INSURANCE CONSULTING, INC. | 1143 SHIPWATCH CIRCLE TAMPA, FL 33602 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 12.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 ADMINISTRATORS | Consulting fees; Contract Administrator Service code 13 | 2001 CALDWELL DRIVE GOODLETTSVILLE, TN 37072 | $90K |
| EXPRESS SCRIPTS EIN 43-1420563 RX DISCOUNT | Claims processing Service code 12 | ONE EXPRESS WAY ST. LOUIS, MO 63121 | $74K |
| CIGNA HEALTHCARE EIN 06-0303370 PPO DISCOUNT | Claims processing Service code 12 | 1111 MARKET STREET CHATTANOOGA, TN 37402 | $31K |
| TED SOILEAU CPA LLC EIN 45-1621265 ACCOUNTANT | Accounting (including auditing) Service code 10 | 2133 SILVERSIDE DRIVE, SUITE C BATON ROUGE, LA 70808 | $24K |
| BRANSTETTER, KILGORE, STRANCH & JEN EIN 62-0513048 LEGAL | Legal Service code 29 | 223 ROSA L. PARKS AVENUE, SUITE 200 NASHVILLE, TN 37203 | $16K |
| UBS FINANCIAL SERVICES, INC. EIN 13-2638116 INVESTMENT CUSTODIAN | Account maintenance fees; Distribution (12b-1) fees; Securities brokerage commissions and fees Service code 63 | 1285 AVENUE OF THE AMERICAS NEW YORK, NY 10019 | $50 |
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 | 82 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 82 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 82 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.