| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, LLC3 Filed as: ALLIED BENEFIT SYSTEMS INC | — | WESTPORT INSURANCE CORPORATION | $138K | — | $138K | 31.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERIVCES, INC | 1900 NORTH WINSTON ROAD SUITE 100 KNOXVILLE, TN 37919 | WESTPORT INSURANCE CORPORATION | $95K | — | $95K | 21.90% |
| TELADOC3 | — | WESTPORT INSURANCE CORPORATION | $10K | — | $10K | 2.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | 1900 NORTH WINSTON ROAD SUITE 100 KNOXVILLE, TN 37919 | ONEAMERICA | $14K | — | $14K | 10.00% |
| JENNINGS INSURANCE SERVICES3 Filed as: JENNINGS INSURANCE SRVCS | 10524 MOSS PARK ROAD 204-306 ORLANDO, FL 32832 | ONEAMERICA | — | $3K | $3K | 2.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | 1900 N WINSTON ROAD SUITE 100 KNOXVILLE, TN 37919 | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | $13K | — | $13K | 10.22% |
| MARSH & MCLENNAN AGENCY LLC3 | 605 3RD AVENUE FLOOR 24 NEW YORK, NY 10158 | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | — | $3K | $3K | 2.66% |
| MARSH & MCLENNAN AGENCY LLC3 | LIBERTY TOWER SUITE 500 605 CHESTNUT STREET CHATTANOOGA, TN 37450 | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | $2K | — | $2K | 1.35% |
No Schedule C service providers reported on this filing.
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 | 396 | 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) | 396 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | 506 | $126K |
| Vision | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | 506 | $126K |
| Life insurance | ONEAMERICA | 446 | $142K |
| Short-term disability | ONEAMERICA | 446 | $142K |
| Long-term disability | ONEAMERICA | 446 | $142K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 220 | $433K |
| Other | ONEAMERICA | 446 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 506 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.