| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COX HEALTH SYSTEMS INSURANCE CO3 Filed as: COX HEALTH SYSTEMS INSURANCE COMP | PO BOX 5750 SPRINGFIELD, MO 658015750 | COX HEALTH SYSTEMS INSURANCE COMPANY | — | $65K | $65K | 7.50% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF RD SCHAUMBURG, IL 60173 | COX HEALTH SYSTEMS INSURANCE COMPANY | $21K | — | $21K | 2.38% |
| ASSURANCE AGENCY LTD3 | 1 CENTURY CENTER 1750 EAST GOLF ROAD OSAGE BEACH, IL 60173 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $6K | $13K | 10.75% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 1750 E GOLF ROAD 11TH FLOOR SCHAUMBURG, IL 60173 | AMERITAS | $2K | — | $2K | 5.99% |
| FRINGE INSURANCE BENEFITS, INC.3 | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | AMERITAS | $2K | — | $2K | 5.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 S JEFFERSON SUITE 600-N SPRINGFIELD, MO 65806 | AMERITAS | $2K | — | $2K | 4.01% |
| FRINGE INSURANCE BENEFITS, INC.3 | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | NATIONWIDE LIFE INSURANCE COMPANY | $3K | — | $3K | 6.71% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD 11TH FLOOR SCHAUMBURG, IL 60173 | NATIONWIDE LIFE INSURANCE COMPANY | $2K | — | $2K | 5.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 S JEFFERSON SUITE 600-N SPRINGFIELD, MO 65806 | NATIONWIDE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FRINGE INSURANCE BENEFITS, INC. EIN 74-2616364 ADMINISTRATION | Contract Administrator Service code 13 | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | $33K |
| ASSURANCE AGENCY LTD EIN 36-2656887 SERVICE PROVIDER | Insurance brokerage commissions and fees Service code 53 | 1750 E GOLF ROAD 11TH FLOOR SCHAUMBURG, IL 60173 | $10K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 SERVICE PROVIDER | Insurance brokerage commissions and fees Service code 53 | 300 S. JEFFERSON SUITE 600-N SPRINGFIELD, MO 65806 | $7K |
| FIRST HEALTH EIN 20-1736437 SERVICE PROVIDER | Insurance brokerage commissions and fees Service code 53 | 3200 HIGHLAND AVENUE DOWNERS GROVE, IL 60515 | $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 | 182 | 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) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $157K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $157K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $157K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $157K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $118K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.