| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 3625 N ELM ST 200 GREENSBORO, NC 53188 | COMMUNITY INSURANCE COMPANY | $11K | $311 | $11K | 35.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD SUITE 202 WAUKESHA, WI 53188 | COMMUNITY INSURANCE COMPANY | $294 | — | $294 | 0.90% |
| MARSH & MCLENNAN AGENCY LLC3 | 3625 N ELM ST 200 GREENSBORO, NC 27455 | COMMUNITY INSURANCE COMPANY | $3K | $685 | $4K | 16.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 ADMINISTRATOR | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Contract Administrator Service code 12 | — | $339K |
| HUB INTERNATIONAL MIDWEST LTD BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | $0 |
| MARSH & MCLENNAN AGENCY LLC BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | $0 |
| INGENIORX INC. EIN 82-3062245 RX BENEFIT PLAN | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue Service code 12 | — | -$74K |
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. |
| 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | COMMUNITY INSURANCE COMPANY | 548 | $33K |
| Life insurance | COMMUNITY INSURANCE COMPANY | 107 | $23K |
| Short-term disability | COMMUNITY INSURANCE COMPANY | 107 | $23K |
| Long-term disability | COMMUNITY INSURANCE COMPANY | 107 | $23K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 548 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.