| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL ST 4TH FLOOR BOSTON, MA 02110 | TRANSAMERICA LIFE INSURANCE COMPANY | $13K | — | $13K | 8.97% |
| EXCELSIOR BENEFITS LLC3 | 23505 SMITHTOWN RD STE 200 EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPANY | $5K | — | $5K | 3.72% |
| ROBERT M NOE3 | 422 WESTBRIDGE DR KNOXVILLE, TN 37919 | TRANSAMERICA LIFE INSURANCE COMPANY | $404 | — | $404 | 0.28% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY, INC | 225 KENNETH DR ROCHESTER, NY 14623 | TRANSAMERICA LIFE INSURANCE COMPANY | $39 | — | $39 | 0.03% |
| RSC INSURANCE BROKERAGE INC3 | 3696 N FEDERAL HWY STE 202 FORT LAUDERDALE, FL 33308 | GUARDIAN | $17K | $1K | $18K | 12.85% |
| RSC INSURANCE BROKERAGE INC3 | 3696 N FEDERAL HWY STE 202 FORT LAUDERDALE, FL 33308 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $2K | $11K | 24.50% |
| RSC INSURANCE BROKERAGE INC3 | 3696 N FEDERAL HWY STE 202 FORT LAUDERDALE, FL 33308 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $950 | $269 | $1K | 19.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH BENEFITS EIN 35-1846036 NONE | Plan Administrator; Claims processing; Other services Service code 12 | — | $173K |
| LAROCCA & ASSOCIATES EIN 59-2406398 NONE | Consulting (general); Insurance agents and brokers Service code 16 | — | $70K |
| AETNA EIN 06-6033492 NONE | Claims processing; Other services Service code 12 | — | $36K |
| HEALTHJOY EIN 46-5722012 NONE | Claims processing Service code 12 | — | $9K |
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 | 160 | 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) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA LIFE INSURANCE COMPANY | 214 | $143K |
| Dental | GUARDIAN | 215 | $141K |
| Vision | GUARDIAN | 215 | $141K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $6K |
| Other(3 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 277 | $194K |
| 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.