| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JIM BARTON & ASSOCIATES, INC.3 Filed as: JIM BARTON & ASSOCIATES | P.O. BOX 476 GRANVILLE, OH 43023 | PRUDENTIAL | $3K | — | $3K | 7.99% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL | — | $80 | $80 | 0.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $257K |
| JIM BARTON & ASSOCIATES, INC EIN 31-0846076 BROKER | Other commissions Service code 55 | P.O. BOX 476 GRANVILLE, OH 43023 | $53K |
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 | 716 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 716 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL | 213 | $37K |
| Long-term disability | PRUDENTIAL | 213 | $37K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 716 | $409K |
| Other | PRUDENTIAL | 213 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 716 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.