| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EVERETT INSURANCE AGENCY, INC. Filed as: EVERETT INSURANCE AGENCY INC | 1913 EAST 17TH ST #214 SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | $25K | $0 | $25K | 3.70% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY, INC | P O BOX 11177 SOUTH BEND, IN 46634 | UNITEDHEALTHCARE INSURANCE COMPANY | $31K | — | $31K | 4.97% |
| GIBSON INSURANCE AGENCY, INC. Filed as: GIBSON INSURANCE AGENCY | 333 E JEFFERSON ST PLYMOUTH, IN 46563 | GUARDIAN LIFE INSURANCE COMPANY | $26K | — | $26K | 9.42% |
| GIBSON INSURANCE AGENCY, INC. | 333 E JEFFERSON ST PLYMOUTH, IN 46563 | HEALTH ALLIANCE PLAN | $5K | $0 | $5K | 3.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGER | Direct payment from the plan; Other fees; Claims processing; Float revenue Service code 12 | — | $456K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $93K |
| GIBSON INSURANCE AGENCY EIN 35-1116724 BROKER | Other commissions Service code 55 | — | $11K |
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 | 263 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 543 | $278K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY | 543 | $278K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 543 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.