| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 4TH FL 160 FEDERAL STREET BOSTON, MA 02110 | GUARDIAN LIFE INSURANCE COMPANY OF AMEERICA | $9K | — | $9K | 15.00% |
| OPES ONE ADVISORS LLC3 | 15303 DALLAS PARKWAY STE 550 ADDISON, TX 75001 | GUARDIAN LIFE INSURANCE COMPANY OF AMEERICA | $43 | — | $43 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 06-0303370 NETWORK ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $17K |
| ORCHESTRATEHR EIN 27-4567072 THIRD PARTY ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $14K |
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Consulting fees; Consulting (general) Service code 16 | — | $9K |
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 | 104 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 83 | $218K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMEERICA | 104 | $58K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMEERICA | 104 | $58K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMEERICA | 104 | $58K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 83 | $218K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 83 | $218K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMEERICA | 104 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.