| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TENTH DOT BENEFITS SOLUTIONS LLC3 Filed as: TENTH DOT BENEFITS SOLUTIONS INC | 444 LIBERTY AVENUE FOUR GATEWAY STE 750 PITTSBURGH, PA 15222 | MINNESOTA LIFE INSURANCE COMPANY | — | $35K | $35K | 6.50% |
| BENEFITS ADVISORS SERVICES GROUP3 Filed as: BENEFITS ADVISORS SERVICES GRP LLC | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | MINNESOTA LIFE INSURANCE COMPANY | — | $1K | $1K | 0.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK INC. EIN 23-1294723 PLAN SPONSOR | Contract Administrator Service code 13 | — | $670K |
| MERCER TRUST CO. EIN 13-2834414 NONE | Actuarial Service code 11 | — | $472K |
| DIAMOND HILL NONE | Investment management Service code 28 | 325 JOHN H MCCONNELL BLVD COLUMBUS, OH 43215 | $246K |
| SEYFARTH SHAW EIN 36-2152202 NONE | Legal Service code 29 | — | $101K |
| BNY MELLON BANK EIN 25-0659306 NONE | Trustee (directed) Service code 25 | — | $68K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 SUBSIDIARY OF PLANSPONSOR | Contract Administrator Service code 13 | — | $57K |
| SHENKMAN NONE | Investment management Service code 28 | 461 5TH AVE NEW YORK, NJ 10017 | $45K |
| BAKER TILLY VIRCHOW KRAUSE, LLP EIN 39-0859910 NONE | Accounting (including auditing) Service code 10 | — | $35K |
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 | 4,252 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 4,252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HIGHMARK INC. - FREEDOM BLUE | 2,252 | $8.8M |
| Vision | HM LIFE INSURANCE COMPANY | 3,472 | $221K |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 3,854 | $534K |
| Prescription drug | HIGHMARK INC. - BLUE RX | 118 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,854 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.