| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GEORGE G NOLEN3 Filed as: GEORGE G. NOLEN | TWO N 20TH STREET - SUITE 1500 BIRMINGHAM, AL 35203 | THE HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | P.O. BOX 744833 ATLANTA, GA 30374 | VISION SERVICE PLAN | $1K | — | $1K | 5.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 63-0103830 INSURANCE | Insurance services; Claims processing Service code 12 | — | $299K |
| MARSH & MCLENNAN AGENCY, LLC EIN 26-3237576 BROKER | Insurance agents and brokers Service code 22 | — | $54K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | 201 E. OREGON RD, STE 100 LITITZ, PA 17543 | $24K |
| CONNECTCARE3, LLC EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | 201 E. OREGON RD, STE 100 LITITZ, PA 17543 | $8K |
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 | 129 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HM INSURANCE GROUP | 133 | $374K |
| Dental | BLUE CROSS BLUE SHIELD | 129 | $75K |
| Vision | VISION SERVICE PLAN | 112 | $23K |
| Life insurance(2 contracts, 2 carriers) | THE HARTFORD LIFE AND ACCIDENT | 175 | $43K |
| Short-term disability(2 contracts, 2 carriers) | THE HARTFORD LIFE AND ACCIDENT | 175 | $43K |
| Long-term disability | THE HARTFORD LIFE AND ACCIDENT | 175 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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."
No prospect flags tripped on this filing.