| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOUDOUN INSURANCE GROUP3 | 5 WIRT STREET SW, STE 300 LEESBURG, VA 20175 | AETNA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 4.32% |
| OSPREY CONTRACTOR CONSULTING3 | 315 E. ROBINSON STREET, STE 660 ORLANDO, FL 32801 | AETNA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 1.30% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY INC. | 6300 BRIDGEPOINT PKWY, BLDG 3 AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 16.77% |
| OSPREY CONTRACTOR CONSULTING3 | 315 EAST ROBINSON STREET, STE 660 ORLANDO, FL 32801 | TRANSAMERICA LIFE INSURANCE COMPANY | $72 | $0 | $72 | 0.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON ADMINISTRATIVE SERVICES EIN 33-0449333 NONE | Float revenue; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $66K |
| HEALTHY ACHIEVERS EIN 02-0478132 NONE | Other services Service code 49 | — | $8K |
| AMERIDOC EIN 04-3705970 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $6K |
| BOON ADMINSTRATIVE SERVICES, INC. | Float revenue Service code 62 | — | $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 | 96 | 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) | 96 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 574 | $455K |
| Life insurance | TRANSAMERICA LIFE INSURANCE COMPANY | 176 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 574 | — |
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.