| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CYPRESS BENEFIT ADMINISTRATORS, LLC3 Filed as: CYPRESS BENEFIT ADMINISTRATORS LLC | 5500 W. GRANDE MARKET DR APPLETON, WI 54913 | MONTGOMERY MANAGEMENT | — | $35K | $35K | 16.90% |
| MARK GALL HLU CONSULTANTS3 | 2144 GILBERT AVE CINCINNATI, OH 45206 | MONTGOMERY MANAGEMENT | — | $33K | $33K | 15.96% |
| PREMIER HEALTHCARE EXCHANGE3 | 2 CROSSROADS DR BEDMINSTER, NJ 07921 | MONTGOMERY MANAGEMENT | — | $18K | $18K | 8.54% |
| AKESO CARE MANAGEMENT3 | 2960 NORTH MERIDAN ST INDIANAPOLIS, IN 46208 | MONTGOMERY MANAGEMENT | — | $3K | $3K | 1.34% |
| SAGAMORE HEALTH NETWORK3 Filed as: SAGAMORE HEALTHCARE EXCHANGE | 11595 N MERIDAN ST. STE 600 CARMEL, IN 460326910 | MONTGOMERY MANAGEMENT | — | $104 | $104 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CYPRESS BENEFIT ADMINISTRATORS LLC EIN 39-1997579 | Claims processing Service code 12 | 5560 W. GRANDE MARKET DR APPLETON, WI 54913 | $0 |
| MARK GALL HLU CONSULTANTS EIN 31-0622691 | Custodial (securities) Service code 19 | 2144 GILBERT AVE CINCINNATI, OH 45206 | $0 |
| PREMIER HEALTHCARE EXCHANGE EIN 60-1040704 | Other fees Service code 99 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $0 |
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 | 121 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MONTGOMERY MANAGEMENT | 121 | $207K |
| Dental | MONTGOMERY MANAGEMENT | 121 | $207K |
| Prescription drug | MONTGOMERY MANAGEMENT | 121 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.