| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 Filed as: NEBCO/AMWINS | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE COMPANY | $40K | — | $40K | 11.94% |
| DIETRICH & ASSOCIATES3 | 1000 GERMANTOWN PIKE SUITE K-1 PLYMOUTH MEETING, PA 19462 | TRANSAMERICA INSURANCE COMPANY | $20K | — | $20K | 6.10% |
| WEB TPA | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | TRANSAMERICA INSURANCE COMPANY | $13K | — | $13K | 3.91% |
| AMWINS5 Filed as: NEBCO/AMWINS | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | STONEBRIDGE LIFE INSURANCE | $17K | — | $17K | 6.67% |
| DIETRICH & ASSOCIATES3 | 1000 GERMANTOWN PIKE SUITE K-1 PLYMOUTH MEETING, PA 19462 | STONEBRIDGE LIFE INSURANCE | $11K | — | $11K | 4.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIFTH THIRD BANK EIN 31-1051736 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Custodial (other than securities) Service code 15 | — | $15K |
| GROSS, PUCKEY, GRUEL & ROOF, P.C. EIN 38-2962645 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $8K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 148 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Prescription drug | STONEBRIDGE LIFE INSURANCE | 143 | $257K |
| Other | TRANSAMERICA INSURANCE COMPANY | 153 | $335K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.