| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | BLUE CROSS BLUE SHIELD OF KANSAS CITY | $46K | — | $46K | 4.91% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $5K | $13K | 14.10% |
| ACRISURE LLC3 | 2625 W PETERSON AVE CHICAGO, IL 60659 | PRINCIPAL LIFE INSURANCE COMPANY | — | $692 | $692 | 0.75% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | PRINCIPAL LIFE INSURANCE COMPANY | $616 | — | $616 | 0.67% |
| BXA INSURANCE SERVICES3 | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 4.36% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | KAISER FOUNDATION HEALTH PLAN INC. | $355 | — | $355 | 0.46% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | DELTA DENTAL OF MISSOURI | $2K | — | $2K | 5.09% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | VISION SERVICE PLAN | $337 | — | $337 | 5.65% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $55 | — | $55 | 0.92% |
No Schedule C service providers reported on this filing.
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 216 | $1.0M |
| Dental | DELTA DENTAL OF MISSOURI | 250 | $31K |
| Vision | VISION SERVICE PLAN | 119 | $6K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $92K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $92K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $92K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 216 | $1.0M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 160 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.