| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | $75K | — | $75K | 14.94% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | IRONSHORE INDEMNITY INC. | $57K | — | $57K | 14.94% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 65808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| MED-PAY, INC.3 | PO BOX 10909 SPRINGFIELD, MO 658081600 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MED-PAY, INC. EIN 43-1318969 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 10909 SPRINGFIELD, MO 65808 | $115K |
| UCS HOLDINGS INC. EIN 81-5149270 PPO NETWORK ACCESS FEES | Other fees Service code 99 | — | $44K |
| ARKANSAS MANAGED CARE ORGANIZATION EIN 71-0792653 PPO NETWORK ACCESS FEES | Other fees Service code 99 | — | $8K |
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 | 611 | 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) | 611 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 614 | $98K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 623 | $18K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 611 | $882K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 614 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 623 | — |
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.