| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 99 PARK AVE 25TH FLOOR NEW YORK, NY 10016 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $108K | — | $108K | 0.30% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $7K | $7K | 0.02% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 99 PARK AVE 25TH FLOOR NEW YORK, NY 10016 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 3.79% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPSYCH EIN 35-3739783 NONE | Other insurance fees and expenses; Contract Administrator Service code 13 | — | $76K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 79,219 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 79,219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(20 contracts, 20 carriers) | KAISER FOUNDATION HEALTH PLAN INC, SO. CA | 1,854 | $30.7M |
| Dental | AETNA INC. | 1,969 | $487K |
| Life insurance(8 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 51,273 | $65.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 51,273 | — |
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.