| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $117 | $117 | 0.05% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1828 S EL CAMINO REAL SAN MATEO, CA 94402 | VSP | $957 | — | $957 | 1.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES EIN 31-1582098 PLAN SERVICE PROVIDER | Contract Administrator Service code 13 | — | $89K |
| CBIZ BENEFITS & INSURANCE SERVICES, PLAN SERVICE PROVIDERR | Contract Administrator Service code 13 | 175 S MAIN STE 720 SALT LAKE CITY, UT 84101 | $0 |
| CLIFTONLARSONALLEN, LLC EIN 41-0746749 NONE | Accounting (including auditing) Service code 10 | — | $0 |
| COMPSYCH EIN 35-3739789 NONE | Contract Administrator Service code 13 | — | $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 | 534 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 534 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 440 | $105K |
| Vision | VSP | 252 | $76K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 523 | $222K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 523 | $222K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 523 | $222K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 523 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 523 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.