| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL SPECIAL RISKS | 1899 POWERS FERRY ROAD, SUITE 100 ATLANTA, GA 30339 | HCC LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTHCARE EIN 36-2739571 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $434K |
| BPA OF WISCONSIN INC. EIN 39-1400101 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $265K |
| LEE JOST & ASSOCIATES EIN 39-1400101 NONE | Consulting (general); Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $64K |
| FREYBERG HINKLE ET AL EIN 39-1531945 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $13K |
| US BANK EIN 39-1042490 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $9K |
| BUILDING TRADES UNITED PENSION EIN 51-6049409 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $8K |
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 | 405 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 168 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 573 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 430 | $359K |
| Other | AIG BENEFIT SOLUTIONS, MEDICAL EXCESS | 436 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.