| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST STATE INSURANCE AGENCY3 | 204 E. LIBERTY STREET FARMINGTON, MO 63640 | XCHANGE BENEFITS | $30K | — | $30K | — |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES, INC. | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | XCHANGE BENEFITS | $15K | — | $15K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| XCHANGE BENEFITS LLC EIN 27-3463029 STOP LOSS INS CARRIER | Other fees Service code 99 | 200 BUSINESS PARK DRIVE STE 303 ARMONK, NY 10504 | $300K |
| GROUP BENEFIT SERVICES, INC. EIN 43-1770779 CLAIMS ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | $37K |
| PHCS / MULTIPLAN EIN 13-3068979 PPO NETWORK | Other fees Service code 99 | 3345 MICHELSON DR, STE 200 IRVINE, CA 92612 | $37K |
| FIRST STATE INSURANCE EIN 43-1239952 BROKER | Other fees Service code 99 | 204 E LIBERTY STREET FARMINGTON, MO 63640 | $30K |
| GROUP BENEFIT SERVICES EIN 43-1770779 BROKER | Other fees Service code 99 | 1736 E. SUNSHINE ST, STE 200 SPRINGFIELD, MO 65804 | $15K |
| HEALTHLINK OPEN ACCESS III EIN 43-1364135 PPO NETWORK | Other fees Service code 99 | 1000 WEST NIFONG BUILDING 3 SUITE 200 COLUMBIA, MO 65203 | $11K |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | XCHANGE BENEFITS | 125 | $0 |
| Prescription drug | XCHANGE BENEFITS | 125 | $0 |
| Stop-loss / reinsurancereinsurance | XCHANGE BENEFITS | 125 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.