| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | QBE INSURANCE CORPORATION | $82K | — | $82K | 38.74% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $718 | — | $718 | 10.00% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $558 | — | $558 | 10.01% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $356 | — | $356 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MED-PAY, INC. EIN 43-1318969 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 10909 SPRINGFIELD, MO 65808 | $83K |
| PAY.GOV TRANSITIONAL REINSURANCE | Other fees Service code 99 | — | $72K |
| UNITED CLAIM SOLUTIONS PPO WRAP NETWORK ACCESS | Other fees Service code 99 | — | $20K |
| PREMIER HEALTHCARE EXCHANGE PPO WRAP NETWORK ACCESS | Other fees Service code 99 | — | $16K |
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 | 373 | 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) | 373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(4 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 369 | $50K |
| Long-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 369 | $11K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 373 | $211K |
| Other(4 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 369 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.