| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 | 300 N BEACH ST DAYTONA BEACH, FL 32114 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $43K | $10K | $52K | 3.75% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE OF NV | 8337 W SUNSET RD STE 150 LAS VEGAS, NV 89113 | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 13.54% |
| US NATIONAL BENEFIT PARTNERS WEST3 Filed as: U.S. NATIONAL BENEFIT PARTNERS | 99 WOOD AVE SOUTH SUITE 501 ISELIN, NJ 08830 | SYMETRA LIFE INSURANCE COMPANY | — | $416 | $416 | 1.55% |
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 | 151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 177 | $1.4M |
| Dental | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 152 | $130K |
| Vision | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 152 | $130K |
| Life insurance | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 152 | $130K |
| Short-term disability | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 152 | $130K |
| Long-term disability | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 152 | $130K |
| Other(2 contracts, 2 carriers) | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 152 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.