| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $6K | 15.95% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, TN 18018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.98% |
| BSI CORPORATE BENEFITS LLC3 | 28411 NORTHWESTERN HWY STE 1150 SOUTHFIELD, MI 480345567 | METROPOLITAN LIFE INSURANCE COMPANY | $865 | $106 | $971 | 10.51% |
| JOE FERNANDEZ3 | 7500 DALLAS PKWY STE 550 PLANO, TX 750244019 | METROPOLITAN LIFE INSURANCE COMPANY | $732 | $218 | $950 | 10.28% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $360 | $222 | $582 | 16.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BSI CORPORATE BENEFITS EIN 51-0467698 BROKER | Insurance agents and brokers Service code 22 | — | $70K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $21K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $7K |
| INNOVU BROKER | Insurance agents and brokers Service code 22 | 2403 SIDNEY ST SUITE 225 PITTSBURGH, PA 15203 | $6K |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | METROPOLITAN LIFE INSURANCE COMPANY | 36 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $4K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $35K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 114 | $439K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.