| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INSURANCE COMPANY MEDICARE SUPPLEMENT | $11K | — | $11K | 4.63% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | UNITED AMERICAN INSURANCE COMPANY MEDICARE SUPPLEMENT | $7K | — | $7K | 2.75% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | ELIXIR INSURANCE COMPANY PRESCRIPTION DRUG PLAN | $11K | — | $11K | 4.74% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS. SERV. | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | ELIXIR INSURANCE COMPANY PRESCRIPTION DRUG PLAN | $8K | — | $8K | 3.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Direct payment from the plan; Investment management; Investment management fees paid indirectly by plan; Insurance services Service code 23 | — | $181K |
| BCBSMN,INC-DBA BLUECROSS BLUESHIELD EIN 41-0984460 NONE | Float revenue; Claims processing; Insurance brokerage commissions and fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Legal; Direct payment from the plan; Other commissions; Contract Administrator; Insurance agents and brokers; Other fees Service code 12 | — | $78K |
| BCBSMN INC DBA BLUECROSS BLUESHIELD | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Legal Service code 12 | — | $71K |
| HESS MORGAN HOUSE LLC EIN 56-2559267 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $26K |
| PRINCIPAL TRUST COMPANY NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 15 | 711 HIGH STREET DES MOINES, IA 50392 | $22K |
| EXTEND HEALTH, INC. EIN 26-0775680 NONE | Contract Administrator; Direct payment from the plan; Consulting (general) Service code 13 | — | $20K |
| BAKER TILLY US, LLP EIN 39-0859910 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $18K |
| HEALTH EQUITY, INC. - DBA FURTHER EIN 52-2383166 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $11K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 984 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 984 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED AMERICAN INSURANCE COMPANY MEDICARE SUPPLEMENT | 85 | $259K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 613 | $81K |
| Prescription drug | ELIXIR INSURANCE COMPANY PRESCRIPTION DRUG PLAN | 85 | $240K |
| Stop-loss / reinsurancereinsurance | ELIXIR INSURANCE COMPANY PRESCRIPTION DRUG PLAN | 85 | $240K |
| Other | HARTFORD LIFE AND ACCIDENT | 217 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 613 | — |
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.