| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| XL BENEFIT INSURANCE SERVICES3 | — | COMPANION LIFE INSURANCE COMPANY | $10K | — | $10K | 4.00% |
| JAMES A BLESSINGER AGY LLC3 Filed as: JAMES A. BLESSINGER AGENCY, LLC | PO BOX 549 JASPER, IN 475470549 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 14.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPANION LIFE | Contract Administrator; Claims processing Service code 12 | — | $189K |
| PAN AMERICAN LIFE | Claims processing; Contract Administrator Service code 12 | — | $55K |
| PROFESSIONAL BENEFIT ADMINISTRATORS THIRD PARTY ADMIN | Claims processing; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Accounting (including auditing); Plan Administrator; Investment advisory (plan); Participant communication; Copying and duplicating Service code 10 | 900 JORIE BLVD SUITE 250 OAK BROOK, IL 60523 | $45K |
| ASPIRANT EIN 87-4144306 ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | — | $40K |
| UNITED HEALTHCARE | Claims processing; Custodial (securities) Service code 12 | — | $15K |
| PATOKA VALLEY | Claims processing; Contract Administrator Service code 12 | — | $14K |
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 | 167 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 179 | $32K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 131 | $262K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.