| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 29100 NORTHWESTERN HWY SUITE 310 SOUTHFIELD, MI 48034 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $3K | $0 | $3K | 9.59% |
| BSI CORPORATE BENEFITS LLC3 | 79 WEST MARKET STREET BETHLEHEM, PA 18018 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 17.00% |
| BSI CORPORATE BENEFITS LLC3 | 79 WEST MARKET STREET BETHLEHEM, PA 18018 | RELIANCE STANDARD | $1K | $0 | $1K | 17.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | RELIANCE STANDARD | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $48K |
| BSI CORPORATE BENEFITS BROKER | Insurance agents and brokers Service code 22 | 79 WEST MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | $36K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| TELEDOC/HEALTHIEST YOU EIN 04-3705970 ADMIN | Claims processing Service code 12 | — | $5K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
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 | 67 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 69 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CAPITAL ADVANTAGE ASSURANCE COMPANY | 85 | $32K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 85 | $32K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 67 | $10K |
| Long-term disability | RELIANCE STANDARD | 67 | $8K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 62 | $133K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 67 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 85 | — |
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."
No prospect flags tripped on this filing.