| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $5K | $5K | 1.24% |
| HEALTHCARE MANAGEMENT ADMINISTRATOR3 | — | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $5K | $5K | 1.18% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | METROPOLITAN LIFE INSURANCE COMPANY | — | $15 | $15 | 0.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WA, INC. | — | VISION SERVICE PLAN | $926 | — | $926 | 6.23% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 3.44% |
| LAURABETH CHRISTENSEN3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 1.65% |
| JOEL N NEWMAN AGENCY LLC3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.51% |
| CALEB ANTHONY LAW3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.38% |
| COREY HULSEY3 Filed as: COREY ZINICOLA | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.29% |
| WHITFIELD BENEFIT SOLUTIONS3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.16% |
| REBECCA J. COTTER3 Filed as: REBECCA J COTTER | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $229 | — | $229 | 8.13% |
| STOOKSBERRY INSURANCE AGENCY LLC3 | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $97 | — | $97 | 3.45% |
| T ALLEN HOWDESHELL3 Filed as: ALLEN V HUNDLEY | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $52 | — | $52 | 1.85% |
| COTTER CONSULTING & BENEFITS INC3 | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $21 | $12 | $33 | 1.17% |
| JAMEY MILLER INC3 Filed as: JAMEY J MILLER | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $32 | — | $32 | 1.14% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM C COVINGTON | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $25 | — | $25 | 0.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: CHARNETTE L WILLIS | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $24 | — | $24 | 0.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $20 | — | $20 | 0.71% |
| RALPH H KEELER3 Filed as: RALPH S MANN | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $13 | — | $13 | 0.46% |
| SAIC INC3 | 1639 BRADLEY PARK DR ST 500 BOX 358 COLUMBUS, GA 31904 | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $9 | — | $9 | 0.32% |
| JOSPEH A NASCA3 Filed as: JOSPEH N MCBRIDE | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $7 | — | $7 | 0.25% |
| NANCY LAPHAM3 Filed as: NANCY L WALDNER | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $5 | $2 | $7 | 0.25% |
| CHARLES H WEISSBERGER3 | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $3 | $2 | $5 | 0.18% |
| JOHN TODD LEE3 | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $1 | — | $1 | 0.04% |
| STAN A SHERLIN3 | — | AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS | $1 | — | $1 | 0.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | — | FIRST CHOICE HEALTH | $256 | — | $256 | 9.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 NONE | Contract Administrator Service code 13 | — | $70K |
| BROWN & BROWN OF WASHINGTON, INC. EIN 91-1622053 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $40K |
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 | 106 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 324 | $109K |
| Vision | VISION SERVICE PLAN | 97 | $15K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 74 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $18K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 94 | $423K |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.