| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS | 921-C S. MCPHERSON CHURCH ROAD FAYETTEVILLE, NC 28303 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24K | — | $24K | 6.65% |
| THE FIN PROCESS GROUP3 | 8140 MOPAC BLVD BLD 1 SUITE 230 AUSTIN, TX 78759 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $304 | — | $304 | 0.09% |
| EBENCONCEPTS COMPANY3 | 5050 SPRING VALLEY ROAD DALLAS, TX 75244 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $43K | $7K | $50K | 22.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS HEALTHPLAN OF GEORGIA INC. EIN 58-1638390 PLAN ADMINISTRATION | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Other fees; Claims processing Service code 12 | — | $176K |
| EBENCONCEPTS EIN 75-2966596 CONSULTANT | Consulting (general); Consulting fees Service code 16 | — | $55K |
| EXPRESS SCRIPTS, INC. EIN 16-1279199 PBM | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | $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 | 536 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 536 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 536 | $355K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 536 | $355K |
| Life insurance(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 536 | $845K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 438 | $228K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 438 | $228K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 443 | $262K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 438 | $228K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 536 | — |
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.