| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NAUGHT-NAUGHT AGENCY3 | 1441 CHRISTY DRIVE JEFFERSON CITY, MO 65101 | PAN-AMERICAN LIFE INSURANCE | $17K | — | $17K | — |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES, INC. | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 658041328 | PAN-AMERICAN LIFE INSURANCE | $9K | — | $9K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP BENEFIT SERVICES, INC. EIN 43-1770779 PLAN ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Plan Administrator Service code 12 | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 658041328 | $38K |
| HEALTHLINK OPEN ACCESS II EIN 43-1364135 PPO NETWORK | Other fees Service code 99 | 1000 WEST NIFONG BLDG. 3, STE. 200 COLUMBIA, MO 65203 | $10K |
| ADVANCED MEDICAL PRICING SOLUTIONS EIN 20-2149357 MEDICAL REVIEW | Other fees Service code 99 | PO BOX 921695 NORCROSS, GA 30010 | $7K |
| PHCS / MULTIPLAN EIN 13-3068979 PPO NETWORK | Other fees Service code 99 | 3345 MICHELSON DRIVE, STE. 200 IRVINE, CA 92612 | $7K |
| MANAGED CARE CONCEPTS EIN 86-0799129 PRECERT/CASE REVIEW | Other fees Service code 99 | 416 DONNELL ORANGE, TX 77630 | $6K |
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 | 166 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PAN-AMERICAN LIFE INSURANCE | 166 | $0 |
| Prescription drug | PAN-AMERICAN LIFE INSURANCE | 166 | $0 |
| Stop-loss / reinsurancereinsurance | PAN-AMERICAN LIFE INSURANCE | 166 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.