| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AGIS NETWORK INC3 | 2122 KRATKY ROAD SAINT LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 9.45% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 4.72% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $56 | $56 | 0.04% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $9 | $9 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREFERREDONE ADMINISTRATIVE SERVICE EIN 41-1846481 ASO HLTH | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Participant communication; Non-monetary compensation; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $80K |
| COMPSYCH EIN 35-3739793 TPA FEES | Contract Administrator; Claims processing Service code 12 | — | $2K |
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 | 309 | 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) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREFERRED ONE INSURANCE COMPANY | 533 | $794K |
| Dental | DDMN ASO, LLC (DELTA DENTAL) | 612 | $189K |
| Vision | EYEMED VISION CARE | 358 | $15K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 313 | $136K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 313 | $136K |
| Stop-loss / reinsurancereinsurance | PREFERRED ONE INSURANCE COMPANY | 533 | $794K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 313 | $307K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 612 | — |
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.