| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NETWORK ADMIN INS AGCY INC3 | 4114 LEGATO RD STE 400 FAIRFAX, VA 22030 | SYMETRA LIFE INSURANCE COMPANY | $17K | — | $17K | 6.01% |
| LEAVITT GROUP3 Filed as: BEEHIVE INSURANCE AGENCY | 302 W. 5400 S. SUITE 101 MURRAY, UT 84107 | DENTIST DIRECT, LLC | $3K | — | $3K | 9.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GOVERNMENT SERVICE ADMINISTRATORS EIN 11-3335620 ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $144K |
| CITRIN COOPERMAN & COMPANY, LLP EIN 22-2428965 CPA FIRM/AUDITOR | Accounting (including auditing) Service code 10 | — | $16K |
| BANK OF AMERICA EIN 94-1687665 BANKING SERVICES | Trustee (directed) Service code 25 | — | $14K |
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 | 604 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 604 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 362 | $3.6M |
| Dental(3 contracts, 3 carriers) | CIGNA | 362 | $4.0M |
| Vision(3 contracts, 3 carriers) | CIGNA | 362 | $4.0M |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 39 | $279K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA | 362 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.