| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SBR SERVICES LLC3 | 2839 PACES FERRY ROAD SE SUITE 830 ATLANTA, GA 30339 | HM LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CUSTOM DESIGN BENEFITS, INC. EIN 82-0563218 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 5589 CHEVIOT ROAD CINCINNATI, OH 45247 | $125K |
| HEALTH WORKS EIN 31-1632833 SCREENING CONSULTANT | Other fees Service code 99 | 3914 OAK STREET CINCINNATI, OH 45227 | $150 |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HM LIFE INSURANCE COMPANY | 158 | $242K |
| Prescription drug | HM LIFE INSURANCE COMPANY | 158 | $242K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 158 | $242K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.