| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NAUGHT-NAUGHT AGENCY3 | 1441 CHRISTY DRIVE JEFFERSON CITY, MO 65101 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $20K | — | $20K | — |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES, INC. | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $10K | — | $10K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP BENEFIT SERVICES, INC. EIN 43-1770779 PLAN ADMINISTRATOR | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | $49K |
| HEALTHLINK OA II EIN 43-1364135 PPO NETWORK | Other fees Service code 99 | 1000 WEST NIFONG BUILDING 3 SUITE 200 COLUMBIA, MO 65203 | $11K |
| PHCS / MULTIPLAN EIN 13-3068979 PPO NETWORK | Other fees Service code 99 | 3345 MICHELSON DRIVE, SUITE 200 IRVINE, CA 92612 | $10K |
| MANAGED CARE CONCEPTS EIN 86-0799129 MEDICAL REVIEW | Other fees Service code 99 | 416 DONNELL ORANGE, TX 77630 | $8K |
| ZELIS CLAIMS INTEGRITY INC EIN 86-1040704 PPO NETWORK | Other fees Service code 99 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $7K |
| HEALTHX, INC. EIN 35-1928243 ADMINISTRATOR | Other fees Service code 99 | 9339 PRIORITY WAY W DR #150 INDIANAPOLIS, IN 46240 | $5K |
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 | 177 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 177 | $0 |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 177 | $0 |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 177 | $0 |
| 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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.