| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 200 INTERNATIONAL CIRCLE, SUITE 4500 HUNT VALLEY, MD 21031 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $81K | — | $81K | 4.93% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF WV LLC | 340 MACCORKLE AVENUE SE, SUITE 200 CHARLESTON, WV 25314 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $35K | — | $35K | 2.10% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $32K | — | $32K | 1.93% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $977 | $977 | 0.06% |
| USI INSURANCE SERVICES LLC3 | 418 8TH STREET, SUITE 301 HUNTINGTON, WV 25701 | VISION SERVICE PLAN | $5K | — | $5K | 0.66% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | VISION SERVICE PLAN | $2K | — | $2K | 0.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK INC. ADMINISTRATOR | Contract Administrator Service code 13 | 120 FIFTH AVENUE PITTSBURG, PA 15222 | $1.2M |
| THE PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 ADMINISTRATOR | Contract Administrator Service code 13 | — | $179K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 ADMINISTRATOR | Contract Administrator Service code 13 | — | $107K |
| BENEFIT ASSISTANCE CORPORATION EIN 55-0715869 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $66K |
| 4MOST MANAGED CARE NETWORK EIN 31-1538612 ADMINISTRATOR | Contract Administrator Service code 13 | — | $22K |
| COMPSYCH EIN 35-3739783 ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| USI INSURANCE SERVICES EIN 13-3771734 BROKER | Insurance agents and brokers Service code 22 | — | $3K |
| EMERSON REID LLC EIN 55-0624615 BROKER | Insurance agents and brokers Service code 22 | — | $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 | 2,692 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,727 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,098 | $815K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,017 | $1.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,017 | $1.6M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,017 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,017 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.