| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN BLASCH | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | HARTFORD LIFE AND ACCIDENT | $6K | $3K | $10K | 13.78% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN BLASCH | 71 BEECHWOOD LANE BERKELEY HEIGHTS, NJ 07922 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE EIN 45-2787952 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| ARCHER, BYINGTON, GLENNON, & LEVINE EIN 26-0873462 NONE | Legal; Direct payment from the plan Service code 29 | — | $21K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $21K |
| WELLS FARGO ADVISORS EIN 48-1305000 NONE | Investment management; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $15K |
| EXTREME SYSTEMS SERVICES, LLC EIN 47-2182564 NONE | Other services; Direct payment from the plan Service code 49 | — | $9K |
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 | 1,579 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,579 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,110 | $70K |
| Other | HARTFORD LIFE AND ACCIDENT | 1,110 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,110 | — |
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.