| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST STATE INSURANCE AGENCY3 | 204 E. LIBERTY STREET FARMINTON, MO 63640 | XCHANGE BENEFITS, LLC | $56K | — | $56K | 10.00% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES | 3810 E. SUNSHINE ST, STE 200 SPRINGFIELD, MO 65809 | XCHANGE BENEFITS, LLC | $28K | — | $28K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| XCHANGE BENEFITS, LLC EIN 27-3463029 STOP LOSS INS CARRIER | Other fees Service code 99 | 7550 S. MERIDIAN ST, STE B INDIANAPOLIS, IN 46217 | $556K |
| GROUP BENEFIT SERVICES EIN 43-1770779 THIRD PARTY ADMINISTRATOR | Claims processing; Insurance brokerage commissions and fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Recordkeeping fees; Account maintenance fees Service code 12 | 3810 E. SUNSHINE ST, STE 200 SPRINGFIELD, MO 65809 | $81K |
| FIRST STATE INSURANCE AGENCY EIN 43-1239952 BROKER | Insurance services; Insurance agents and brokers Service code 22 | 204 E. LIBERTY STREET FARMINGTON, MO 63640 | $56K |
| HEALTHLINK OPEN ACCESS III EIN 43-1364135 PPO NETWORK | Other services; Direct payment from the plan Service code 49 | 1000 WEST NIFONG BUILDING 3 STE 200 COLUMBIA, MO 65203 | $16K |
| PHCS / MULTIPLAN EIN 13-3068979 WRAP PPO NETWORK | Other services; Direct payment from the plan Service code 49 | 3345 MICHELSON DR, STE 200 IRVINE, CA 92612 | $8K |
| MEDWATCH, LLC EIN 16-1662117 UTILIZATION REVIEW | Consulting (general); Direct payment from the plan Service code 16 | 400 COLONIAL CENTER PARKWAY STE 320 LAKE MARY, FL 32746 | $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 | 186 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | XCHANGE BENEFITS, LLC | 186 | $556K |
| Prescription drug | XCHANGE BENEFITS, LLC | 186 | $556K |
| Stop-loss / reinsurancereinsurance | XCHANGE BENEFITS, LLC | 186 | $556K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.