| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEWITT INSURANCE AGENCY INC | 13523 BARRETT PARKWAY DR STE #140 BALLWIN, MO 63021 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $4K | $14K | 21.61% |
| DEWITT INSURANCE AGENCY INC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $2K | $4K | 23.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COVENTRY HEALTH CARE OF MISSOURI EIN 43-1372307 NONE | Claims processing; Other fees Service code 12 | — | $396K |
| LISA GOULD EIN 43-1598128 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $144K |
| ANITA VODANOVAC EIN 43-1598128 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $93K |
| SOLON GERSHMAN NONE | Other services; Direct payment from the plan Service code 49 | — | $84K |
| AMALGAMATED BANK OF CHICAGO EIN 36-6228122 NONE | Investment management fees paid directly by plan; Accounting (including auditing); Investment management; Custodial (securities) Service code 10 | — | $60K |
| CHAMARA HUDSON EIN 43-1598128 | Employee (plan); Direct payment from the plan Service code 30 | — | $52K |
| WOLFE NILGES NAHORSKI PC EIN 43-1236296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $41K |
| MARIA HERRERRA EIN 43-1598128 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $30K |
| ANDERS MINKLER HUBER & HELM LLP EIN 43-0831507 NONE | Consulting (general); Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $28K |
| ARLENDA HOLMAN EIN 43-1236296 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $26K |
| HAMMOND AND SHINNERS, PC EIN 43-1429257 NONE | Legal; Direct payment from the plan Service code 29 | — | $22K |
| NETTECH EIN 43-1712583 NONE | Direct payment from the plan; Other services Service code 49 | — | $18K |
| SYSTEM DESIGN ASSOCIATES EIN 43-1228887 NONE | Direct payment from the plan; Other services Service code 49 | — | $16K |
| TFBC, LLC EIN 27-3782504 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $8K |
| TRAVIS SOFTWARE GROUP EIN 76-0191515 NONE | Direct payment from the plan; Other services Service code 49 | — | $7K |
| SEGAL SELECT INSURANCE SERVICES, IN | Insurance brokerage commissions and fees Service code 53 | — | $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 | 585 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 585 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COVENTRY HEALTH CARE OF MISSOURI | 692 | $303K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 613 | $66K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 613 | $66K |
| Life insurance(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 658 | $88K |
| Short-term disability(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 658 | $83K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY | 3 | $5K |
| Stop-loss / reinsurancereinsurance | COVENTRY HEALTH CARE OF MISSOURI | 692 | $303K |
| Other(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 658 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 692 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.