| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 9393 W 110TH ST. STE 600 OVERLAND PARK, KS 66210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 15.00% |
| DIRECTPATH, LLC3 | 120 18TH STREET S, SUITE 102 BIRMINGHAM, AL 35233 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $305 | — | $305 | 3.93% |
| IMA, INC.3 | 1705 17TH ST. STE. 100 DENVER, CO 80202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.30% |
| LAURA E SELKEN4 | 21355 FOXTAIL LN ROGERS, MA 55374 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $192 | — | $192 | 15.50% |
| JULIANA D BRENTESON4 | 2532 183RD ST NW BIG LAKE, MA 55309 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $21 | — | $21 | 1.69% |
| LAURA E SELKEN4 | 21355 FOXTAIL LN ROGERS, MN 55374 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $68 | — | $68 | 6.95% |
| JULIANA D BRENTESON4 | 2532 183RD ST NW BIG LAKE, MN 55309 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $12 | — | $12 | 1.23% |
| DIRECTPATH, LLC3 | 120 18TH STREET S, SUITE 102 BIRMINGHAM, AL 35233 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 8.09% |
| LAURA E SELKEN4 | 21355 FOXTAIL LN ROGERS, MN 55374 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $14 | — | $14 | 6.90% |
No Schedule C service providers reported on this filing.
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | STANDARD INSURANCE COMPANY | 183 | $31K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 43 | $40K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 107 | $26K |
| Other(7 contracts, 4 carriers) | VITAL WORKLIFE | 430 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 430 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.