| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EPSI BENEFITS, INC.3 Filed as: EPSI BENEFITS, INC | 2180 NORTH LOOP WEST SUITE 400 HOUSTON, TX 77018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 115 WEST WAUSAU AVENUE WAUSAU, WI 54401 | $380K |
| EPSI BENEFITS, INC EIN 74-1965813 BROKER | Other commissions Service code 55 | 2180 NORTH LOOP WEST SUITE 400 HOUSTON, TX 77018 | $71K |
| UNITED BEHAVIORAL HEALTH EIN 94-2649097 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | P. O. BOX 30755 SALT LAKE CITY, UT 84130 | $11K |
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 | 256 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 251 | $449K |
| Dental | SYMETRA LIFE INSURANCE COMPANY | 251 | $314K |
| Vision | SYMETRA LIFE INSURANCE COMPANY | 251 | $314K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 256 | $219K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 256 | $219K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 251 | $449K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 256 | $256K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 256 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.