| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 5050 SPRING VALLEY ROAD DALLAS, TX 75244 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $57K | $20K | $77K | 22.98% |
| EBENCONCEPTS COMPANY3 | 5050 SPRING VALLEY ROAD DALLAS, TX 75246 | GUARDIAN LIFE INSURNACE COMPANY OF AMERICA | $19K | — | $19K | 14.82% |
| FINANCIAL PROCESS GROUP3 Filed as: THE FINANCIAL PROCESS GROUP | 8140 MOPAC BLD 1 SUITE 230 AUSTIN, TX 78759 | GUARDIAN LIFE INSURNACE COMPANY OF AMERICA | $24 | — | $24 | 0.02% |
| EBENCONCEPTS COMPANY3 | 5050 SPRING VALLEY ROAD DALLAS, TX 75246 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $9K | 12.00% |
| EBENCONCEPTS COMPANY3 | 5050 SPRING VALLEY ROAD DALLAS, TX 75246 | EYEMED VISION CARE | $3K | — | $3K | 7.08% |
| EBENCONCEPTS COMPANY3 | 921-C S. MCPHERSON CHURCH ROAD FAYETTEVILLE, NC 28303 | UNION SECURITY DENTALCARE OF GEORGIA | $3K | — | $3K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD HEALTHPL EIN 58-1638390 ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $330K |
| EBENCONCEPTS COMPANY, INC. EIN 75-2966596 CONSULTANT | Consulting fees; Consulting (general) Service code 16 | — | $47K |
| EMPLOYERS DIRECT HEALTH, INC. EIN 75-2322062 COBRA ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $7K |
| BLUE CROSS AND BLUE SHIELD OF GEORG EIN 58-0469845 ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other fees; Claims processing; Float revenue Service code 12 | — | $2K |
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 | 639 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 639 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNION SECURITY DENTALCARE OF GEORGIA | 207 | $33K |
| Vision | EYEMED VISION CARE | 828 | $48K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE INSURNACE COMPANY OF AMERICA | 624 | $205K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 639 | $337K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 639 | $468K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 549 | $369K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURNACE COMPANY OF AMERICA | 624 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 828 | — |
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.