| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC5 | 17475 JOVANNA DR. HOMEWOOD, IL 60430 | UNITED STATES FIRE INSURANCE CO. | $4K | $0 | $4K | 1.00% |
| FLINN FINANCIAL, INC.3 | 1150 BOYNE AVENUE BOYNE CITY, MI 49712 | SYMETRA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 10.92% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | ONE ENTERPRISE DR., STE 210 SHELTON, CT 06484 | HARTFORD LIFE & ACCIDENT | $2K | $0 | $2K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC TPA | Consulting (general); Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Insurance services Service code 12 | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | $0 |
| CIGNA NETWORK PROVICER | Claims processing Service code 12 | TWO LIBERTY PLACE 1601 CHESTNUT STREET PHILADELPHIA, PA 19192 | $0 |
| FLINN FINANCIAL, INC. EIN 20-0504030 AGENT | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $0 |
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 | 377 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 377 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 377 | $181K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 377 | $181K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 377 | $181K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE CO. | 326 | $426K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 377 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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.