| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $108K | — | $108K | 0.31% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 0.01% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $39K | — | $39K | 0.23% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $411 | — | $411 | 0.08% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $82 | $82 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPSYCH EIN 35-3739783 NONE | Other insurance fees and expenses; Contract Administrator Service code 13 | — | $74K |
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 | 68,604 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 68,604 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(21 contracts, 21 carriers) | KAISER FOUNDATION HEALTH PLAN INC, SOUTHERN CA | 1,466 | $19.8M |
| Dental | AETNA LIFE INSURANCE CO. | 1,360 | $326K |
| Vision | HM LIFE INSURANCE COMPANY (DAVIS VISION) | 2 | $15 |
| Life insurance(9 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 41,966 | $67.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 41,966 | — |
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.