| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FINANCIAL | 4851 LBJ FRWY, SUITE 100 DALLAS, TX 75244 | SYMETRA LIFE INSURANCE COMPANY | — | $13K | $13K | 2.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $313K |
| VANGUARD EIN 23-2186884 NONE | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 51 | — | $184K |
| BUCK GLOBAL, LLC EIN 13-3954297 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $72K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $40K |
| WOMBLE BOND DICKINSON (US) LLP EIN 56-0308470 NONE | Legal Service code 29 | — | $22K |
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 | 698 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 698 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC STATES, INC. | 32 | $361K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 612 | $505K |
| Prescription drug(3 contracts) | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC STATES, INC. | 32 | $301K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 612 | $439K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 612 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.