| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 | PO BOX 845052 LOS ANGELES, CA 90084 | COMPANION LIFE COLUMBIA, SC | $21K | — | $21K | 5.26% |
| BENEFITS PLANNING SERVICE3 Filed as: BENEFITS PLANNING SVCS | 1200 QUAIL STREET SUITE 105 NEWPORT BEACH, CA 92660 | AMERICAN GENERAL LIFE INS COMPANY | $20K | — | $20K | 10.00% |
| BEFEFITS PLANNING SERVICE3 | 1200 QUAIL STREET SUITE 105 NEWPORT BEACH, CA 92660 | GUARDIAN | $10K | — | $10K | 5.00% |
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL STREET SUITE 105 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE | $5K | — | $5K | 10.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $684 | — | $684 | 6.32% |
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL ST SUITE 105 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $663 | — | $663 | 6.13% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $614 | — | $614 | 5.67% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $207 | $74 | $281 | 2.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $168K |
| BENEFITS PLANNING SERVICE EIN 33-0421912 BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $144K |
| CIGNA HEALTH & LIFE COMPANY EIN 59-1031071 PPO & UR VENDOR | Other fees; Direct payment from the plan Service code 50 | — | $92K |
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 | 572 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 573 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 596 | $202K |
| Vision | EYEMED VISION CARE | 780 | $47K |
| Life insurance | AMERICAN GENERAL LIFE INS COMPANY | 1,105 | $202K |
| Short-term disability | AMERICAN GENERAL LIFE INS COMPANY | 1,105 | $202K |
| Long-term disability | AMERICAN GENERAL LIFE INS COMPANY | 1,105 | $202K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE COLUMBIA, SC | 556 | $393K |
| Other(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INS COMPANY | 1,105 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,105 | — |
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.