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| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $87K |
| CAPITAL ADVANTAGE ASSURANCE COMPANY EIN 45-5492167 ADMIN | Claims processing Service code 12 | — | $67K |
| BSI CORPORATE BENEFITS, LLC EIN 51-0467698 BROKER | Insurance agents and brokers Service code 22 | — | $42K |
| HY HOLDINGS INC EIN 04-3705970 OTHER | Other services Service code 49 | — | $16K |
| INNOVU EIN 81-1938789 OTHER | Other services Service code 49 | — | $7K |
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 | 386 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 386 | $111K |
| Vision | VISION SERVICE PLAN | 152 | $18K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 189 | $155K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 189 | $155K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 189 | $155K |
| Stop-loss / reinsurancereinsurance | AVALON INSURANCE COMPANY | 154 | $365K |
| Other | HARTFORD LIFE AND ACCIDENT | 189 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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.