| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT BUILDERS LLC3 Filed as: BENEFIT BUILDERS INC. | 7777 WASHINGTON VILLAGE DR. SUITE 170 DAYTON, OH 454593976 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | — | $15K | 7.48% |
| FIELD UNDERWRITERS AGENCY INC3 Filed as: FIELD UNDERWRITERS AGENCY INC. | 7777 WASHINGTON VILLAGE DR. SUITE 170 DAYTON, OH 454593976 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 2.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCESS RE EIN 73-0714500 NONE | Insurance services; Claims processing Service code 12 | — | $144K |
| JP FARLEY CORP EIN 34-1363719 NONE | Contract Administrator Service code 13 | — | $56K |
| BENEFIT BUILDERS EIN 31-1483106 NONE | Insurance agents and brokers Service code 22 | — | $33K |
| MULTIPLAN EIN 13-3068979 NONE | Insurance services Service code 23 | — | $7K |
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 | 216 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $206K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $206K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $206K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $206K |
| Stop-loss / reinsurancereinsurance(2 contracts) | GERBER LIFE INSURANCE COMPANY | 138 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.