| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GOLDENCARE USA INC3 | 10700 COUNTY RD 15, STE 450 MINNEAPOLIS, MN 55410 | TRABSAMERICA LIFE INSURANCE COMPANY | $567 | — | $567 | 0.71% |
| AMERICAN IND MKTG3 | PO BOX 9366 YAKIMA, WA 98909 | TRABSAMERICA LIFE INSURANCE COMPANY | $566 | — | $566 | 0.71% |
| EDUCATORS LIFETIME SOLUTIONS LLC3 Filed as: EDUCATORS LIFETIME SOLUTIONS | 440 EMERSON STREET NORTH, SUITE 2 CAMBRIDGE, MN 55008 | GENWORTH LIFE INSURANCE COMPANY | $4K | — | $4K | 10.27% |
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 | 163 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other(2 contracts, 2 carriers) | TRABSAMERICA LIFE INSURANCE COMPANY | 179 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.