| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTH COST SOLUTIONS, INC.3 | P.O. BOX 1439 HENDERSONVILLE, TN 37077 | PHOENIX EXCESS RISK UNDERWRITER/GERBER LIFE | $28K | — | $28K | 11.11% |
| SIMMONS FIRST INSURANCE SERVICES3 | PO BOX 810 HUMBOLDT, TN 383430810 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | — | $15K | 20.00% |
| SIMMONS FIRST INSURANCE SERVICES3 | 8245 TOURNAMENT DR STE 295 MEMPHIS, TN 381251739 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $3K | $12K | 16.69% |
| SIMMONS FIRST INSURANCE SERVICES3 | PO BOX 810 HUMBOLDT, TN 383430810 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| SIMMONS FIRST INSURANCE SERVICES3 | PO BOX 810 HUMBOLDT, TN 383430810 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AHDI EIN 35-2048379 | Contract Administrator Service code 13 | — | $0 |
| HEALTH COST SOLUTIONS EIN 62-1115925 | Contract Administrator Service code 13 | — | $0 |
| HSTECHNOLOGY SOLUTIONS, INC. EIN 27-1818792 | Contract Administrator Service code 13 | — | $0 |
| INNOVATIVE CARE MGMT EIN 93-1087669 | Contract Administrator Service code 13 | — | $0 |
| NATIONAL PHARMACEUTICAL SERVICES EIN 47-0764793 | Contract Administrator Service code 13 | — | $0 |
| PHCS EIN 04-3138814 | Contract Administrator Service code 13 | — | $0 |
| RISK SOLUTIONS CAPTIVE INC. EIN 46-3092480 | 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 | 250 | 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) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 339 | $74K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 339 | $74K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 347 | $24K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 60 | $75K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 60 | $57K |
| Stop-loss / reinsurancereinsurance | PHOENIX EXCESS RISK UNDERWRITER/GERBER LIFE | 149 | $248K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 347 | — |
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.