| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICES, INC | 4870 SADLER RD GLEN ALLEN, VA 23060 | SYMETRA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 2.40% |
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICES INC | 1120 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | SYMETRA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 1.79% |
| CFA LLC | 1501 S. CLINTON STREET BALTIMORE, MD 21224 | SYMETRA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 1.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST BLUECROSS BLUESHIELD EIN 53-0078070 CONTRACT ADMINISTRATOR | Contract Administrator; Consulting (general); Insurance services; Direct payment from the plan; Float revenue; Claims processing; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $147K |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 CONTRACT ADMINISTRATOR | Claims processing; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Direct payment from the plan; Insurance services; Other fees Service code 12 | — | $80K |
| CVS CAREMARK EIN 05-0304626 CONTRACT ADMINISTRATOR | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other fees; Contract Administrator; Consulting (general); Insurance services; Direct payment from the plan Service code 12 | — | $19K |
| COMERICA BANK EIN 42-1741646 DIRECTED TRUSTEE | Other fees; Other services; Trustee (bank, trust company, or similar financial institution); Shareholder servicing fees; Custodial (securities); Float revenue; Other investment fees and expenses; Investment management Service code 19 | — | $5K |
| BDO USA, P.C. EIN 13-5381590 PLAN AUDITOR | Accounting (including auditing) Service code 10 | — | $5K |
| SCHWARTZ & CO. EIN 38-2117812 INVESTMENT ADVISOR | Investment advisory (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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 290 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 173 | $347K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.