| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | — | $12K | $12K | 11.26% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP-NATIONAL ACCOUNT SERVICES, INC. | 340 MADISON AVENUE, 21ST FLOOR NEW YORK, NY 10173 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 36-1236610 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $517K |
| THE SEGAL COMPANY (MIDWEST), INC EIN 13-1975125 NONE | Actuarial; Non-monetary compensation; Direct payment from the plan; Consulting (general) Service code 11 | — | $96K |
| KOVITZ INVESTMENT GROUP EIN 91-2198169 NONE | Investment management; Direct payment from the plan Service code 28 | — | $81K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Copying and duplicating Service code 13 | — | $67K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $20K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE | Securities brokerage commissions and fees; Other investment fees and expenses; Finders' fees / placement fees; Float revenue; Custodial (securities) Service code 19 | — | $17K |
| EMPLOYEE RESOURCE SERVICES, INC EIN 36-3867645 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $16K |
| MEKETA INVESTMENT GROUP, INC EIN 04-2659023 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $11K |
| SIERRA INVESTMENT PARTNERS, INC EIN 68-0370668 NONE | Direct payment from the plan; Investment management Service code 28 | — | $9K |
| ASHER, GITTLER, GREENFIELD & D'ALBA EIN 36-2786883 NONE | Legal; Direct payment from the plan Service code 29 | — | $8K |
| DISABATO AND ASSOCIATES EIN 35-2323525 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $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 | 701 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 701 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 731 | $39K |
| Vision | VISION SERVICE PLAN | 722 | $110K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 740 | $41K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 731 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 740 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.