| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT CAPTIVE RE3 Filed as: BENEFIT CAPTIVE RE, LLC | 505 3RD STREET, STE 200 DES MOINES, IN 50309 | UNITED STATES FIRE INSURANCE COMPANY | $48K | — | $48K | 10.77% |
| HEALTH SCOPE BENEFITS INC3 Filed as: HEALTH SCOPE BENEFITS | 305 MADISION AVENUE MORRISTOWN, NJ 07960 | UNITED STATES FIRE INSURANCE COMPANY | — | $34K | $34K | 7.49% |
| AIG BENEFIT SOLUTIONS3 Filed as: AIG | 3600 ROUTE 66 NEPTUNE, NJ 07753 | UNITED STATES FIRE INSURANCE COMPANY | — | $15K | $15K | 3.40% |
| PHCS3 Filed as: MULTIPLAN PHCS | 115 FIFTH AVENUE NEW YORK, NY 10003 | UNITED STATES FIRE INSURANCE COMPANY | — | $6K | $6K | 1.35% |
| MEDTRAK SERVICES3 Filed as: MEDTRAK SERVICES, LLC | 7101 COLLEGE BLVD, STE 1000 OVERLAND PARK, KS 66210 | UNITED STATES FIRE INSURANCE COMPANY | — | $6K | $6K | 1.35% |
| HEALTHCARE STRAGETIS3 Filed as: HEALTHCARE STRATEGIES | 9841 BROKEN LAND PARKWAY STE 315 COLUMBIA, MD 21046 | UNITED STATES FIRE INSURANCE COMPANY | — | $5K | $5K | 1.08% |
| CLAIM DOC LLC3 | 100 SW ALBANY AVE, STE 200 STUART, FL 34994 | UNITED STATES FIRE INSURANCE COMPANY | — | $3K | $3K | 0.75% |
| MD LIVE, INC.3 Filed as: MD LIVE | 11630 NW 8TH STREET, STE 205 SUNRISE, FL 33325 | UNITED STATES FIRE INSURANCE COMPANY | — | $2K | $2K | 0.37% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 N FIRST ST STE #202 SAN JOSE, CA 95112 | LINCOLN FINANCIAL GROUP | $10K | — | $10K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 N FIRST ST STE #202 SAN JOSE, CA 95112 | LINCOLN FINANCIAL GROUP | $2K | — | $2K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 N 1ST ST STE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $1K | — | $1K | 10.00% |
| VARIOUS3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $227 | — | $227 | 4.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT CAPTIVE RE LLC EIN 81-0993536 NONE | Insurance agents and brokers Service code 22 | 506 3RD STREET STE 200 DES MOINES, IA 50309 | $48K |
| HEALTH SCOPE BENEFITS EIN 71-0847266 NONE | Claims processing Service code 12 | 27 CORPORATE WAY DRIVE LITTLE ROCK, AR 72205 | $34K |
| AIG EIN 25-0687550 NONE | Insurance services Service code 23 | 3600 ROUTE 66 NEPTUNE, NJ 07753 | $15K |
| RON FILICE ENTERPRISES INC EIN 77-0261203 NONE | Insurance agents and brokers Service code 22 | 738 N 1ST STREET STE 202 SAN JOSE, CA 95112 | $13K |
| MULTIPLAN PHCS EIN 13-3068979 NONE | Insurance services Service code 23 | 115 FIFTH AVENUE NEW YORK, NY 10003 | $6K |
| MEDTRAK SERVICES LLC EIN 36-4221427 NONE | Insurance services Service code 23 | 7101 COLLEGE BLVD STE 1000 OVERLAND PARK, KS 66210 | $6K |
| HEALTHCARE STRATEGIES EIN 52-1874471 NONE | Claims processing Service code 12 | 9841 BROKEN LAND PARKWAY COLUMBIA, MD 21046 | $5K |
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 | 103 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED STATES FIRE INSURANCE COMPANY | 103 | $448K |
| Dental | LINCOLN FINANCIAL GROUP | 118 | $101K |
| Vision | VISION SERVICE PLAN | 113 | $13K |
| Life insurance | LINCOLN FINANCIAL GROUP | 177 | $18K |
| Short-term disability(2 contracts, 2 carriers) | LINCOLN FINANCIAL GROUP | 177 | $23K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE COMPANY | 103 | $448K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.