| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURANCE & BENEFITS | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $30K | — | $30K | 12.27% |
| MCB SOLUTIONS3 | 1795 ALYSHEBA WAY STE 1204 LEXINGTON, KY 40509 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 3.57% |
| NORTHWEST ENROLLRX LLC3 | 7656 TWP RD 94 FINDLAY, OH 45840 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $5K | $6K | 2.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH BENEFITS, INC EIN 35-1846036 CLAIMS/ADMIN | Plan Administrator; Other services; Claims processing Service code 12 | — | $109K |
| KEYSTONE INSURANCE & BENEFITS GROUP EIN 27-0367008 BROKER | Consulting (general); Insurance agents and brokers Service code 16 | — | $49K |
| HIGHMARK, INC EIN 23-1294723 CLAIMS/ADMIN | Other services; Claims processing Service code 12 | — | $42K |
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 | 189 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $247K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $247K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $247K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $247K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.