| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARRINGTON HEALTH3 | 780 BROOKSEDGE PLAZA DR WESTERVILLE, OH 430814914 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 11.89% |
| PETRICH BENEFIT PLAN SERVICES, INC.3 Filed as: PETRICH BENEFIT PLAN SERVICES INC | 345 N RIVERVIEW STE 600 WICHITA, KS 67203 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $844 | — | $844 | 1.11% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $110 | $110 | 0.14% |
| HARRINGTON HEALTH3 Filed as: HARRINGTON HEALTH SVCS INC. | 780 BROOKSEDGE PLAZA DR WESTERVILLE, OH 43081 | HARTFORD LIFE AND ACCIDENT | $10K | $852 | $11K | 19.07% |
| HARRINGTON BENEFIT SERVICES, INC.3 Filed as: HARRINGTON BENEFIT SERVICES | PO BOX 3 WICHITA, KS 67201 | UNUM LIFE INSURANCE COMPANY | $4K | — | $4K | 14.15% |
| PETRICH BENEFIT PLAN SERVICES, INC.3 Filed as: PETRICH BENEFIT PLAN SERVICES | 345 N RIVERVIEW STE 600 WICHITA, KS 67203 | UNUM LIFE INSURANCE COMPANY | $201 | — | $201 | 0.74% |
| HARRINGTON HEALTH3 | P.O. BOX 2697 WICHITA, KS 67201 | ZURICH AMERICAN INSURANCE COMPANY | $400 | — | $400 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HARRINGTON BENEFIT SERVICES, INC. EIN 41-1982309 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 780 BROOKSEDGE PLAZA WESTERVILLE, OH 43081 | $53K |
| ALLEN, GIBBS & HOULIK, LC EIN 48-1032601 AUDITOR | Accounting (including auditing) Service code 10 | 301 NORTH MAIN STE 1700 WICHITA, KS 67202 | $0 |
| AMERICAN HEALTH HOLDINGS UTILIZATION REVIEW | Other insurance fees and expenses Service code 73 | 100 W OLD WILSON BRIDGE WORTHINGTON, OH 430856016 | $0 |
| PETRICH BENEFIT SERVICES INC EIN 27-1197779 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 345 N RIVERVIEW STE 600 WICHITA, KS 67203 | $0 |
| WPPA INC DBA PROVIDERS CARE NETWORK PPO PROVIDER NETWORK | Insurance services Service code 23 | 1102 S. HILLSIDE WICHITA, KS 67211 | $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 | 227 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 315 | $76K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 80 | $55K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 80 | $55K |
| Stop-loss / reinsurancereinsurance | STANDARD LIFE & ACCIDENT INSURANCE COMPANY | 227 | $212K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 315 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.