| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY, INC. | 6300 BRIDGEPOINT PARKWAY BLDG 3, STE 500 AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $29K | $0 | $29K | 5.50% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY, INC. | 6300 BRIDGEPOINT PARKWAY BLDG 3, STE 500 AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 17.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON ADMINISTRATIVE SERVICES, INC. EIN 33-0449333 NONE | Direct payment from the plan; Float revenue; Contract Administrator; Claims processing Service code 12 | 6300 BRIDGEPOINT PKWY BLDG 3, STE 500 AUSTIN, TX 78730 | $93K |
| HOLTZMAN PARTNERS EIN 74-3121060 NONE | Accounting (including auditing) Service code 10 | 1710 WEST SIXTH STREET AUSTIN, TX 78703 | $13K |
| HEALTHY ACHIEVERS EIN 02-0478132 NONE | Other services Service code 49 | — | $12K |
| AMERIDOC EIN 04-3705970 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $7K |
| MD LIVE EIN 45-4937055 NONE | Other services Service code 49 | — | $7K |
| BOON ADMINSTRATIVE SERVICES, INC. | Float revenue Service code 62 | — | $0 |
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 | 187 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 116 | $529K |
| Life insurance | TRANSAMERICA LIFE INSURANCE COMPANY | 187 | $18K |
| Other | TRANSAMERICA LIFE INSURANCE COMPANY | 187 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.