| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $0 | $12K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFITS CONSULTANTS | 300 S 4TH STREET, SUTIE 704 LAS VEGAS, NV 891016023 | HM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NC 89101 | PRINCIPAL LIFE INSURANCE COMPANY | $404 | $0 | $404 | 9.99% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | ACE AMERICAN INSURANCE COMPANY | $137 | $0 | $137 | 19.94% |
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 | 297 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 690 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 987 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | 355 | $640K |
| Vision | HM LIFE INSURANCE COMPANY | 613 | $24K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 827 | $121K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 173 | $85K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 124 | $30K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 355 | $499K |
| Other(2 contracts, 2 carriers) | COMPSYCH | 296 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 827 | — |
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.