| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MIDWEST PENSION & PROFIT SHARING SV3 Filed as: MIDWEST PENSION & PROFIT SHARING SE | 121 S 8TH ST STE 630 MINNEAPOLIS, MN 55402 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $15K | — | $15K | — |
| JOHN M EISENHART3 | 10250 REGENCY CIRCLE OMAHA, NE 68114 | MASSACHUSETTS LIFE INSURANCE COMPANY | $6 | — | $6 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MASSACHUSETTS MUTUAL LIFE INS CO EIN 04-1590850 NONE | Other investment fees and expenses; Soft dollars commissions; Sub-transfer agency fees; Distribution (12b-1) fees; Investment management fees paid indirectly by plan; Recordkeeping fees; Other insurance wrap fees Service code 52 | 1295 STATE STREET SPRINGEFIELD, MA 01111 | $38K |
| MIDWEST PENSION & PROFIT SHARING SE | Contract Administrator Service code 13 | — | $12K |
| MASSACHUSETTS MUTUAL LIFE INSURANCE | Sub-transfer agency fees; Other investment fees and expenses; Other insurance wrap fees Service code 60 | — | $0 |
| MIDWEST PENSION & PROFIT SHG SVCS EIN 41-1447816 NONE | Insurance brokerage commissions and fees; Contract Administrator Service code 13 | 121 SOUTH 8TH STREET SUITE 630 MINNEAPOLIS, MN 55402 | $0 |
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 | 298 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | 323 | $0 |
| Other | MASSACHUSETTS LIFE INSURANCE COMPANY | 1 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.