| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, | $8K | — | $8K | 12.08% |
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.00% |
| OPEN ACQ LLC3 Filed as: OPEN ONE ADVISORS LLC | 15303 DALLAS PARKWAY STE 550 ADDISON, TX 75001 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $375 | — | $375 | 1.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ORCHESTRATEHR EIN 27-4567072 THIRD PARTY AD | Claims processing; Other fees Service code 12 | — | $24K |
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Other fees; Consulting (general) Service code 16 | — | $13K |
| COMPSYCH EIN 35-3739783 TPA | Other fees; 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 | 96 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 96 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 71 | $206K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 73 | $36K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 73 | $36K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, | 96 | $66K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, | 96 | $66K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, | 96 | $66K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 71 | $206K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 71 | $206K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, | 96 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 96 | — |
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."
No prospect flags tripped on this filing.