| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SUDLER INSURANCE SERVICES INC | 5034 NW 112 WAY CORAL SPRINGS, FL 33076 | AETNA HEALTH, INC. | $162K | — | $162K | 2.97% |
| SUDLER INSURANCE SERVICES INC | 5034 NW 112 WAY CORAL SPRINGS, FL 33076 | AETNA LIFE INSURANCE CO. | $8K | — | $8K | 1.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSOCIATED ADMINISTRATORS, LLC EIN 65-1205077 ADMINISTRATOR | Direct payment from the plan; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | — | $99K |
| THE SEGAL COMPANY EIN 13-2619259 ACTUARY | Direct payment from the plan; Actuarial Service code 11 | — | $42K |
| KSDT & CO, LLC EIN 26-0547877 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $17K |
| PHILLIPS, RICHARD & RIND, P.A. EIN 65-0765728 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $17K |
| UNITED MEMBERS INSURANCE, INC. EIN 59-3006151 INSURANCE AGENT | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $9K |
| SEI INVESTMENT MANAGERS EIN 23-1707341 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Investment management Service code 28 | — | $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 | 604 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 610 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 1,462 | $525K |
| Dental | AETNA LIFE INSURANCE CO. | 1,462 | $525K |
| Vision | AETNA LIFE INSURANCE CO. | 1,462 | $525K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 747 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,462 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.