| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| N/A3 | — | ANTHEM INSURANCE COMPANIES | $0 | — | $0 | 0.00% |
| THE INSURANCE EXCHANGE INC3 Filed as: THE INSURANCE EXCHANGE INC. | 9713 KEY WEST AVE STE 401 ROCKVILLE, MD 20850 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $907 | $12K | 16.25% |
| THE INSURANCE EXCHANGE INC3 | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $149 | $3K | 5.90% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $83 | $83 | 0.16% |
| THE INSURANCE EXCHANGE INC3 | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNUM LIFE INSURANCE OF AMERICA | $2K | $30 | $2K | 4.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 CLAIMS PROCESSOR | Other commissions; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 12 | — | $591K |
| INSURANCE EXCHANGE, INC. | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $131K |
| ANTHEM INSURANCE COMPANIES, INC. | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $86K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 RX PROVIDER | Other fees; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 9246 PORTAGE INDUSTRIAL DR. PONTAGE, MI 49024 | $11K |
| BASIC EIN 38-2883561 COBRA ADMIN FEES | Direct payment from the plan; Contract Administrator Service code 13 | — | $8K |
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 | 1,034 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,041 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | ANTHEM INSURANCE COMPANIES | 469 | $610K |
| Life insurance(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 816 | $355K |
| Short-term disability(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 816 | $283K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 816 | $232K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES | 469 | $610K |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 816 | $352K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 816 | — |
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."
No prospect flags tripped on this filing.