| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 Filed as: UMR | 115 WEST WAUSAU AVENUE WAUSAU, WI 54401 | NATIONWIDE LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GULF COAST | 600 JEFFERSON ST SUITE 200 LAFAYETTE, LA 70501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 11.65% |
| AXA ASSISTANCE, USA3 Filed as: SOUTHERN NATIONAL MARKETING COMPANY | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 7.33% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 6.83% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP, LLC | 18700 N. HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | TOKIO MARINE HCC | $1K | $629 | $2K | 15.41% |
| PSG/COGNETA3 | 14881 QUORUM DRIVE SUITE 850 DALLAS, TX 75254 | MAXORPLUS, LTD. | $6K | $3K | $9K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $70K |
| ASSUREDPARTNERS GULF COAST INSUR AG EIN 46-4936799 BROKER | Other commissions Service code 55 | — | $24K |
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 | 91 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 91 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 126 | $73K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 126 | $73K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 126 | $73K |
| Prescription drug | MAXORPLUS, LTD. | 136 | $0 |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 92 | $157K |
| Other | TOKIO MARINE HCC | 91 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.