| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE INC3 Filed as: RELATION INSURANCE | 3930 E JONES BRIDGE ROAD SUITE 210 PEACHTREE CORNERS, GA 30092 | GREAT MIDWEST INSURANCE COMPANY | $79K | — | $79K | 11.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS LLC EIN 36-3086057 TPA | Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $177K |
| RELATION INSURANCE EIN 26-4823657 BROKER | Insurance agents and brokers; Insurance services Service code 22 | — | $103K |
| AETNA LIFE INSURANCE CO EIN 06-6033492 INSURANCE SVCES | Insurance services Service code 23 | — | $56K |
| INNOVU LLC PLAN CONSULTANT | Consulting fees Service code 70 | 2403 SIDNEY ST SUITE 225 PITTSBURGH, PA 15203 | $15K |
| GOPIVOT SOLUTIONS LLC PLAN CONSULTANT | Consulting fees Service code 70 | 3565 PIEDMONT ROAD NE SUITE 700 ATLANTA, GA 30305 | $13K |
| AMINO INC PLAN CONSULTANT | Consulting fees Service code 70 | 25 TAYLOR STREET SUITE 208 SAN FRANCISCO, CA 94102 | $7K |
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 | 155 | 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) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | GREAT MIDWEST INSURANCE COMPANY | 285 | $709K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.