| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 5444 WESTHIEMER, SUITE 900 HOUSTON, TX 77056 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $71K | — | $71K | 15.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1120 SANCTUARY PARKWAY, SUITE 300 ALPHARETTA, GA 30009 | VISION SERVICE PLAN | $936 | — | $936 | 1.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | $239K |
| ANTHEM HEALTH PLANS OF KY, INC. EIN 61-1237516 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Other fees; Float revenue; Other services Service code 12 | — | $172K |
| BANK OF OKLAHOMA, N.A. EIN 73-0780382 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $156K |
| VERISOURCE SERVICES, INC. EIN 76-0554001 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $45K |
| ERNST AND YOUNG LLP EIN 34-6565596 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| RUDD AND WISDOM, INC. EIN 74-1896655 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $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 | 478 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 528 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,006 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 535 | $71K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 314 | $477K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 523 | $386K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 535 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.