| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST FL 4 BOSTON, MA 02110 | TRANSAMERICA LIFE INSURANCE COMPANY | $16K | — | $16K | 9.00% |
| EXCELSIOR BENEFITS LLC3 | 441 2ND STREET EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPANY | $7K | — | $7K | 3.81% |
| ROBERT M NOE3 | 422 WESTBRIDGE DR KNOXVILLE, TN 37919 | TRANSAMERICA LIFE INSURANCE COMPANY | $340 | — | $340 | 0.20% |
| RSC INSURANCE BROKERAGE INC3 | PO BOX 736061 AMS - LEGACY DIRECT BILL RECEI CHIGAGO, IL 60673 | GUARDIAN | $20K | — | $20K | 12.06% |
| RSC INSURANCE BROKERAGE INC3 | PO BOX 736061 AMS - LEGACY DIRECT BILL RECEIPT LO CHIGAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| RSC INSURANCE BROKERAGE INC3 | PO BOX 736061 AMS - LEGACY DIRECT BILL RECEIPT LO CHIGAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | — | $12K | 20.00% |
| RSC INSURANCE BROKERAGE INC3 | 3696 N FEDERAL HWY STE 202 FORT LAUDERDALE, FL 33308 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.66% |
| RSC INSURANCE BROKERAGE INC3 | PO BOX 736061 AMS - LEGACY DIRECT BILL RECEIPT LO CHICAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| RSC INSURANCE BROKERAGE INC3 | PO BOX 736061 AMS LEGACY DIRECT BILL RECEIPT LO CHICAGO, IL 60673 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| RSC INSURANCE BROKERAGE INC3 | 3696 N FEDERAL HWY STE 202 FT LAUDERDALE, FL 33308 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $383 | $383 | 4.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH BENEFITS EIN 35-1846036 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $164K |
| RSC INSURANCE BROKERAGE INC DBA LAR EIN 16-1689464 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | — | $52K |
| AETNA EIN 06-6033492 NONE | Other services; Claims processing Service code 12 | — | $45K |
| LAROCCA & ASSOCIATES, INC. EIN 59-2406398 NONE | Consulting (general); Insurance agents and brokers Service code 16 | — | $36K |
| HEALTHJOY EIN 46-5722012 NONE | Other services; Claims processing Service code 12 | — | $10K |
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 | 198 | 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) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA LIFE INSURANCE COMPANY | 233 | $174K |
| Dental | GUARDIAN | 214 | $168K |
| Vision | GUARDIAN | 214 | $168K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $8K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 50 | $19K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $64K |
| Other(3 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 277 | $239K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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.