| 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 & ACCIDENT INSURANCE COMPANY MEDICARE SUPPLEMENT | $19K | — | $19K | 9.89% |
| WEB TPA5 | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY MEDICARE SUPPLEMENT | $7K | — | $7K | 3.69% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | BENISTAR INC. PRESCRIPTION DRUG PLAN | $9K | — | $9K | 11.30% |
| PATRICIA A. BAYUK3 | NATIONAL RETIREE HEALTH BENEFITS 1738 QUEEN PALM WAY NORTH PORT, FL 34288 | BENISTAR INC. PRESCRIPTION DRUG PLAN | $829 | — | $829 | 1.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WIPFLI LLP EIN 39-0758449 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Trustee (bank, trust company, or similar financial institution); Recordkeeping fees; Direct payment from the plan; Soft dollars commissions Service code 21 | — | $13K |
| BSWIFT NONE | Direct payment from the plan; Consulting (general) Service code 16 | 10 S. RIVERSIDE PLAZA CHICAGO, IL 60606 | $11K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $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 | 324 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY MEDICARE SUPPLEMENT | 66 | $187K |
| Prescription drug | BENISTAR INC. PRESCRIPTION DRUG PLAN | 66 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 66 | — |
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.