| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, LLC5 Filed as: ALLIED BENEFIT SYSTEMS, INC | 200 WEST ADAMS ST SUITE 500 CHICAGO, IL 60606 | HCC LIFE INSURACNE COMPANY | $89K | — | $89K | 20.54% |
| PHCS | — | HCC LIFE INSURACNE COMPANY | $10K | — | $10K | 2.42% |
| HENRIOTT GROUP INC3 Filed as: HENRIOTT GROUP, INC. | 250 MAIN STREET SUITE 650 LAFAYETTE, IN 47901 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | — | $15K | 9.22% |
| HENRIOTT GROUP INC Filed as: HENRIOTT GROUP, INC. | 250 MAIN STREET SUITE 650 LAFAYETTE, IN 47901 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS | — | $3K | $3K | 10.15% |
| HENRIOTT GROUP INC3 Filed as: HENRIOTT GROUP, INC | 250 MAIN STREET SUITE 650 LAFAYETTE, IN 47901 | FEDERAL INSURANCE COMPANY | $0 | $0 | $0 | — |
No Schedule C service providers reported on this filing.
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. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS | 570 | $28K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 545 | $160K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 545 | $160K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 545 | $160K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURACNE COMPANY | 218 | $433K |
| Other | FEDERAL INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 570 | — |
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.