| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (NY) | 340 MADISON AVENUE 21ST FLOOR NEW YORK, NY 10173 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $34K | $0 | $34K | 1.93% |
| JOHN R. THORBAHN INS AGNCY INC3 Filed as: JOHN REHM THORBAHN III | 141 LONGWATER DR STE 101 NORWELL, MA 02061 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 2.41% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10173 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $439 | $3K | 1.48% |
| THORBAHN & ASSOC INSURANCE AGENCY3 | 141 LONGWATER DRIVE, SUITE 101 NORWELL, MA 02061 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 0.80% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HWY BUILDING 2 AUSTIN, TX 78746 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $735 | $735 | 0.39% |
| JOHN R THORBAHN3 Filed as: JOHN R. THORBAHN | 141 LONGWATER DRIVE STE 101 NORWELL, MA 02061 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $186 | $2K | 4.12% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES, NY LLC | 340 MADISON AVENUE, 21ST FLOOR NEW YORK, NY 10173 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $697 | $58 | $755 | 1.76% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TEXAS HIGHWAY BUILDING 2, SUITE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $84 | $84 | 0.20% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES LLC | 340 MADISON AVENUE 21ST FLOOR NEW YORK, NY 10173 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.14% |
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 | 306 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 37 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 306 | $1.8M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 310 | $190K |
| Vision | VISION SERVICE PLAN | 210 | $39K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 310 | $190K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 310 | $190K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 310 | $190K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 306 | $1.8M |
| Other | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 103 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.