| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. DBA TRION GROUP | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 4.73% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET, SUITE 1710 BOSTON, MA 02109 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.99% |
| IMG5 | 2960 NORTH MERIDIAN ST. INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $21 | $21 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD EIN 31-1440175 N/A | Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $317K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 TRUSTEE/INV MGMT | Investment management; Other investment fees and expenses; Recordkeeping and information management (computing, tabulating, data processing, etc.); Trustee (bank, trust company, or similar financial institution) Service code 15 | — | $90K |
| MEADEN & MOORE, LTD. EIN 34-1818258 AUDITOR | Accounting (including auditing) Service code 10 | — | $14K |
| MEDCO HEALTH SOLUTIONS EIN 22-3461740 N/A | Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $12K |
| SEI PRIVATE TRUST COMPANY EIN 04-2452803 TRUSTEE/INV MGMT | Investment management Service code 28 | — | $5K |
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 | 482 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 82 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 504 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.