| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE ST SUITE 1710 BOSTON, MA 02109 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $36K | $36K | 9.18% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE ST SUITE 1710 BOSTON, MA 02109 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $30K | $30K | 7.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $162K |
| PSYBAR LLC NONE | Insurance services Service code 23 | 6600 FRANCE AVENUE SOUTH SUITE 640 EDINA, MN 55345 | $14K |
| ETHOS RISK SERVICE NONE | Insurance services Service code 23 | PO BOX 55246 ST. PETERSBURG, FL 33732 | $9K |
| ALLSUP INC. NONE | Insurance services Service code 23 | 300 ALLSUP PLACE BELLEVILLE, IL 622238626 | $6K |
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 | 5,629 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 120 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,749 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,155 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,155 | — |
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."
No prospect flags tripped on this filing.