| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OSPREY CONTRACTOR CONSULTING3 | 63 INTERLAKEN ORLANDO, FL 32804 | AETNA LIFE INSURANCE COMPANY | $60K | $0 | $60K | 9.54% |
| BARTLEY INSURANCE SERVICES, INC.3 | 3684-A HENDERSON DRIVE JACKSONVILLE, NC 28546 | AETNA LIFE INSURANCE COMPANY | $42K | $0 | $42K | 6.68% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDGEPOINT PARKWAY AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 0.60% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDGEPOINT PARKWAY AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON ADMINISTRATIVE SERVICES, INC. EIN 33-0449333 NONE | Direct payment from the plan; Contract Administrator; Other insurance fees and expenses; Claims processing Service code 12 | — | $571K |
| BOON INSURANCE AGENCY, INC. EIN 74-2236168 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $199K |
| ACTIVE HEALTH EIN 52-2182411 NONE | Other services Service code 49 | — | $48K |
| BSI COMPANIES NONE | Plan Administrator; Insurance agents and brokers Service code 14 | 304 RIDGELAND DRIVE GREENVILLE, SC 29606 | $8K |
| BARTLEY INSURANCE SERVICES, INC. EIN 56-1409682 NONE | Insurance brokerage commissions and fees Service code 53 | — | $0 |
| OSPREY CONTRACTOR CONSULTING EIN 26-2868813 NONE | Insurance brokerage commissions and fees Service code 53 | — | $0 |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing) Service code 10 | — | $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 | 24 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 24 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 0 | $625K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 0 | $661K |
| Stop-loss / reinsurancereinsurance(2 contracts) | GERBER LIFE INSURANCE COMPANY | 135 | $228K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.