| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE INS & BNFTS GRP LLC3 | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | $4K | $20K | 16.43% |
| GIS BENEFITS INC3 | 422 WAUPONSEE IST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $7K | $7K | 5.75% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6K | $6K | 4.64% |
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 2.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NORTH CAR EIN 56-0894904 ADMINISTRATOR | Claims processing Service code 12 | — | $34K |
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 | 118 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 118 | $107K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $119K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $119K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $119K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $119K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 118 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.