| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS3 | 222 W. LAS COLINAS BLVD SUITE 500N IRVING, TX 75039 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 2.00% |
| CHER A. BUMPS & ASSOCIATES, INC.3 Filed as: CHER A BUMPS & ASSOCIATES, INC. | 2601 NW EXPRESSWAY SUITE 1000W OKLAHOMA CITY, OK 73112 | PRUDENTIAL INSURANCE CO. | $2K | — | $2K | 5.55% |
| SCOUT BENEFITS GROUP LLC3 Filed as: SCOUT BENEFITS GROUP, LLC | 414 NW 4TH STREET SUITE 120 OKLAHOMA CITY, OK 73102 | PRUDENTIAL INSURANCE CO. | $808 | — | $808 | 1.94% |
| HEALTHSMART BENEFIT SOLUTIONS3 | P.O. BOX 167429 IRVING, TX 75016 | MEDICAL EXCESS | $2K | — | $2K | 11.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS, INC. EIN 36-4099199 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $45K |
| FIRST HEALTH EIN 20-1736437 PPO PROVIDER | Other services Service code 49 | — | $6K |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 121 | $209K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE CO. | 143 | $69K |
| Long-term disability | SYMETRA LIFE INSURANCE CO. | 143 | $28K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 121 | $209K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE CO. | 143 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.