| 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 | -0.46% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | RELIASTAR LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| BENE RE LLC3 | 5217 MONROE ST STE B TOLEDO, OH 43623 | RELIASTAR LIFE INSURANCE COMPANY | — | $3K | $3K | 8.00% |
| BLOCK, CHARLES, D3 | UNIT 208 648 VILLAGE PARK DRIVE WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $243 | $2K | 6.48% |
| VAN EPPS, JAMES, H3 | 10930 CRABAPPLE ROAD, STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $243 | $2K | 6.48% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNCILMAN MICHAELS AND DOWNS | 555 FAIRMOUNT AVE BALTIMORE, MD 21286 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $4 | $1K | 4.08% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $177 | — | $177 | 0.68% |
| 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% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $211 | $2K | 12.72% |
| VAN EPPS, JAMES, H3 Filed as: VAN EPPS, JAMES | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $210 | $2K | 12.72% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNCILMAN MICHAELS AND DOWNS | 555 FAIRMONT AVE BALTIMORE, MD 21286 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $2 | $1K | 6.85% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $112 | — | $112 | 0.60% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC | BLDG 2, STE 125 1250 CAPITAL OF TEXAS HWY AUSTIN, WI 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | FIRST UNUM LIFE INSURANCE COMPANY | $16 | — | $16 | 1.69% |
| VAN EPPS, JAMES, H3 Filed as: VAN EPPS, JAMES | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | FIRST UNUM LIFE INSURANCE COMPANY | $16 | — | $16 | 1.69% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNCILMAN MICHAELS AND DOWNS | 555 FAIRMOUNT AVE BALTIMORE, MD 21286 | FIRST UNUM LIFE INSURANCE COMPANY | $14 | — | $14 | 1.48% |
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 | 760 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 764 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 638 | $526K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 638 | $506K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 638 | $506K |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE COMPANY | 1,516 | $359K |
| Other(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 638 | $573K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,516 | — |
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.