| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARVARD PRINTING GROUP5 | 175 US HIGHWAY 46 WEST FAIRFIELD, NJ 070042327 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $617 | $617 | 0.15% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 532780001 | RELIASTAR LIFE INSURANCE COMPANY | $9K | — | $9K | 2.24% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | N25W23050 PAUL RD PEWAUKEE, WA 530724078 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 9.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | PO BOX 4386 MISSOULA, MT 598064386 | PRINCIPAL LIFE INSURANCE COMPANY | $532 | — | $532 | 0.81% |
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 | 1,367 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 45 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,412 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 147 | $66K |
| Vision(3 contracts, 2 carriers) | WYSSTA INSURANCE COMPANY INC | 570 | $189K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,795 | $390K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,217 | $420K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 1,795 | $390K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,795 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.