| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONDUENT HR CONSULTING LLC3 | PO BOX 202617 DALLAS, TX 75320 | DELTA DENTAL OF MISSOURI | $0 | $0 | $0 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.97% |
| BUCK GLOBAL LLC3 | PO BOX 207640 DALLAS, TX 75320 | HARTFORD LIFE AND ACCIDENT | — | $317 | $317 | 0.20% |
| INSURANCE PARTNERS AGENCY INC3 Filed as: THE INSURANCE PARTNERS | 11225 COLLEGE BLVD STE 105 OVERLAND PARK, KS 66210 | STANDARD INSURANCE COMPANY | $14K | — | $14K | 14.25% |
| RANDALL K ROST3 Filed as: RANDALL KROST | 368 KINGS RIDGE BLVD OFALLON, IL 62269 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 8.59% |
| MICHAEL ZIMMERMAN3 | 11225 COLLEGE BLVD STE 105 OVERLAND PARK, KS 66210 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 4.57% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $174 | — | $174 | 2.80% |
| STENDER & ASSOCIATES LLC3 | 18102 CHESTERFIELD AIRPORT RD STE A CHESTERFIELD, MO 63005 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $142 | — | $142 | 2.28% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $122 | — | $122 | 1.96% |
| BUCK GLOBAL LLC3 | PO BOX 207640 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | — | $8 | 0.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHY ALLIANCE LIFE INSURANCE CO EIN 86-0257201 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Contract Administrator; Other services; Claims processing; Insurance brokerage commissions and fees; Other commissions; Float revenue Service code 12 | — | $352K |
| DISCOVERY BENEFITS EIN 90-0058554 | Contract Administrator Service code 13 | 4321 20TH AVE SOUTH FARGO, SD 58103 | $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 | 308 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 15 | $6K |
| Dental | DELTA DENTAL OF MISSOURI | 730 | $211K |
| Vision | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 238 | $19K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 324 | $159K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 324 | $255K |
| Stop-loss / reinsurancereinsurance | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 313 | $347K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 358 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 730 | — |
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."
No prospect flags tripped on this filing.