| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 0.72% |
| BLOCK, CHARLES, D3 | UNIT 208 648 VILLAGE PARK DRIVE WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $407 | $3K | 7.74% |
| VAN EPPS, JAMES, H3 | 10930 CRABAPPLE ROAD, STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $383 | $3K | 7.67% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNCILMAN MICHAELS AND DOWNS | 555 FAIRMOUNT AVE BALTIMORE, MD 21286 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $92 | $2K | 5.80% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24 | — | $24 | 0.07% |
| ASSUREX3 | STE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC | BLDG 2, STE 125 1250 CAPITAL OF TEXAS HWY AUSTIN, TX 78746 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
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 | 1,082 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,097 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 1,826 | $331K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 1,826 | $331K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 1,826 | $331K |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE COMPANY | 1,778 | $354K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 319 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,826 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.