| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC3 Filed as: BENEFIT ADMINISTRATIVE SYSTEMS LLC | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | HM LIFE INSURANCE COMPANY | $12K | — | $12K | 5.00% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 8.44% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $57 | $57 | 0.10% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $10 | $10 | 0.02% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | AMERITAS LIFE INSURANCE CORP. | — | $839 | $839 | 2.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATION SYSTEMS, LLC EIN 36-4197088 ADMINISTRATOR | Contract Administrator Service code 13 | — | $154K |
| AMERITAS LIFE INSURANCE CORP. EIN 47-0098400 CONTRACT ADMINISTATOR | Contract Administrator; Claims processing Service code 12 | — | $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 | 340 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP. | 226 | $29K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 341 | $55K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 288 | $232K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 341 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 341 | — |
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.