| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.0 | PO BOX 95287 CHICAGO, IL 60694 | HCC LIFE INSURANCE COMPANY | — | $20K | $20K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Float revenue; Claims processing; Other services; Direct payment from the plan Service code 12 | — | $178K |
| ROBERT PUZA EIN 51-6113680 EMPLOYEE | Direct payment from the plan; Plan Administrator; Employee (plan) Service code 14 | — | $74K |
| AMY GORBY EIN 51-6113680 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| SPENCER RANKIN EIN 51-6113680 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| UNITED ACTUARIAL SERVICES INC. EIN 35-2156428 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $54K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing); Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $52K |
| LEDBETTER PARTNERS, LLC EIN 03-0599899 NONE | Legal; Direct payment from the plan Service code 29 | — | $49K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $25K |
| TOTAL ADMINISTRATIVE SERVICES CORP. EIN 39-1561025 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $12K |
| MARQUETTE ASSOCIATES, INC. EIN 36-3485298 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $8K |
| HEALTHSCOPE BENEFITS EIN 71-0847266 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $6K |
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 244 | $511K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.