| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 1753 PINNACLE DRIVE, 8TH FLOOR MCLEAN, VA 22102 | GHMSI | $190K | $23K | $214K | 3.93% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 18TH FLOOR SAINT LOUIS PARK, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $27 | $8K | 1.96% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $8K | $8K | 1.94% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 601478 CHARLOTTE, NC 28260 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | $890 | $12K | 3.87% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $133 | $133 | 0.04% |
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 | 387 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 395 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GHMSI | 747 | $5.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 951 | $406K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 356 | $313K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 356 | $313K |
| Prescription drug | GHMSI | 747 | $5.4M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 356 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 951 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.