| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY MEDICARE SUPPLEMENT | $109K | — | $109K | 9.96% |
| WEB TPA5 | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY MEDICARE SUPPLEMENT | $36K | — | $36K | 3.29% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | BENISTAR INC. PRESCRIPTION DRUG PLAN | $45K | — | $45K | 9.69% |
| PATRICIA A. BAYUK3 | NATIONAL RETIREE HEALTH BENEFITS 1738 QUEEN PALM WAY NORTH PORT, FL 34288 | BENISTAR INC. PRESCRIPTION DRUG PLAN | $4K | — | $4K | 0.90% |
No Schedule C service providers reported on this filing.
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 | 968 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 968 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY MEDICARE SUPPLEMENT | 351 | $1.1M |
| Prescription drug | BENISTAR INC. PRESCRIPTION DRUG PLAN | 350 | $467K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 351 | — |
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.