| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STREET STE 201 GREENSBORO, NC 27408 | ALL SAVERS INSURANCE COMPANY | $13K | — | $13K | 15.15% |
| SOUTHEAST INSURANCE GROUP INC3 | 2340 HARD SCRABBLE RD COLUMBIA, SC 29223 | ALL SAVERS INSURANCE COMPANY | $5K | — | $5K | 5.59% |
| SOUTHEAST INSURANCE GROUP INC3 | 2340 HARD SCRABBLE RD COLUMBIA, SC 29223 | METLIFE INSURANCE COMPANY | $3K | — | $3K | 9.11% |
| EBENCONCEPTS COMPANY3 | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | METLIFE INSURANCE COMPANY | $251 | — | $251 | 0.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 ADMINISTRATOR | Contract Administrator; Claims processing; Other fees Service code 12 | — | $16K |
| BAY BRIDGE ADMINISTRATORS LLC THIRD PARTY ADMINISTRATOR | Contract Administrator; Other fees; Claims processing Service code 12 | PO BOX 161690 AUSTIN, TX 78716 | $7K |
| SOUTHEAAST INSURANCE GROUP INC THIRD PARTY ADMINISTRATOR | Other fees; Contract Administrator; Claims processing Service code 12 | 2340 HARD SCRABBLE RD COLUMBIA, SC 29223 | $3K |
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 | 35 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 35 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ALL SAVERS INSURANCE COMPANY | 35 | $88K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | ALL SAVERS INSURANCE COMPANY | 35 | $119K |
| Other | METLIFE INSURANCE COMPANY | 22 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 35 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.