| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AVANT SPECIALTY BENEFITS LLC3 | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50283 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 2.60% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $168 | $168 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE ADVANTAGE ADMINISTRATORS OF AR EIN 71-0226428 NONE | Claims processing Service code 12 | — | $538K |
| MAXCARE LLC EIN 47-1448249 NONE | Contract Administrator Service code 13 | — | $62K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 NONE | Contract Administrator Service code 13 | — | $25K |
| CONSOLIDATED ADMIN SERVICE, LLC EIN 80-0504117 NONE | Claims processing Service code 12 | — | $24K |
| COMPSYCH EIN 35-3739783 NONE | 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 | 795 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 800 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 778 | $95K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,148 | $468K |
| Stop-loss / reinsurancereinsurance | GARDEN STATE LIFE INSURANCE COMPANY | 785 | $431K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,148 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.