| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC5 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | AMERICAN FIDELITY ASSURANCE COMPANY | $35K | — | $35K | 5.00% |
| KEY BENEFIT ADMINISTRATORS, INC | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | QBE INSURANCE CORPORATION | $7K | — | $7K | 10.00% |
| EMPLOYEE BENEFIT SERVICES3 Filed as: EMPLOYEE BENEFIT SERVICES, INC. | P.O. BOX 1929 FORT MILL, SC 29716 | SUN LIFE OF CANADA | $209 | — | $209 | 1.00% |
| FIDELITY SECURITY LIFE INSURANCE CO | — | FIDELITY SECURITY LIFE INSURANCE CO. | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC EIN 35-1450364 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $234K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 NONE | Contract Administrator Service code 13 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | $94K |
| MEDCOST EIN 56-1999192 NONE | Contract Administrator Service code 13 | P.O. BOX 896527 CHARLOTTE, NC 28289 | $47K |
| HEALTHCARE BLUEBOOK, INC. EIN 46-4397706 NONE | Contract Administrator Service code 13 | 330 FRANKLIN ROAD STE 135A-42B BRENTWOOD, TN 37027 | $4K |
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 | 625 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 636 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN FIDELITY ASSURANCE COMPANY | 625 | $709K |
| Life insurance | SUN LIFE OF CANADA | 695 | $21K |
| Other(3 contracts, 3 carriers) | QBE INSURANCE CORPORATION | 695 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 695 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.