| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 90A JOHN MUIR DR SUITE 100 AMHERST, NY 14228 | SUN LIFE ASSURANCE COMPANY OF CANADA | $48K | — | $48K | 5.00% |
| UMR, INC.3 | 115 W WAUSAU AVE WAUSA, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 0.59% |
| US BENTEC WORKPLACE SOLUTIONS3 Filed as: US BENTEC WORKPLACE SOLUTIONS LLC | 700 W HILLSBORO BLVD SUITE 2-102 DEERFIELD BEACH, FL 33441 | HARTFORD LIFE AND ACCIDENT | $120K | — | $120K | 26.56% |
| AP BENEFIT ADVISORS, LLC3 | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | HUMANA INSURANCE COMPANY | $11K | — | $11K | 9.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $805K |
| MARATHON HEALTH EIN 26-0103977 NONE | Other services Service code 49 | — | $696K |
| LUMINARE HEALTH BENEFITS EIN 35-1846036 EMPLOYEE ORGANIZATION | Claims processing; Other services; Plan Administrator Service code 12 | — | $330K |
| EMPLOYEE ONE BENEFIT SOLUTIONS LLC EIN 20-8205286 BROKER | Other commissions Service code 55 | 145 W. OSTEND STREET SUITE 200 BALTIMORE, MD 21230 | $222K |
| EXPRESS SCRIPTS, INC EIN 43-1420563 NONE | Other services Service code 49 | — | $24K |
| CHANGE HEALTHCARE EIN 20-5716594 EMPLOYEE ORGANIZATION | Other services; Claims processing Service code 12 | — | $14K |
| MULTIPLAN, INC. EIN 13-3068979 EMPLOYEE ORGANIZATION | Other services; Claims processing; Plan Administrator Service code 12 | — | $12K |
| RX BENEFITS, INC EIN 63-1157085 NONE | Other services Service code 49 | 3700 COLONNADE PKWY STE 600 BIRMINGHAM, AL 35243 | $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 | 2,628 | 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) | 2,628 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 2,014 | $708K |
| Vision | HUMANA INSURANCE COMPANY | 1,072 | $113K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,628 | $1.4M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,628 | $1.4M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,628 | $1.4M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $954K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,371 | $491K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,628 | — |
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.