| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIM LEAKE3 | 3033 NW 63RD ST STE 208 EAST OKLAHOMA CITY, OK 73116 | CERTUS MANAGEMENT GROUP | $60K | — | $60K | 10.00% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES, INC | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | CERTUS MANAGEMENT GROUP | $30K | — | $30K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CERTUS MANAGEMENT GROUP EIN 35-2060150 STOP LOSS INS. CARRIER | Other fees Service code 99 | 300 N MERIDIAN STREET SUITE 1010 INDIANAPOLIS, IN 46204 | $569K |
| GROUP BENEFIT SERVICES, INC. EIN 43-1770779 BROKER | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | 1736 SUNSHINE ST, STE 200 SPRINGFIELD, MO 65804 | $101K |
| AETNA SIGNATURE ADMINISTRATORS EIN 06-6033492 PPO NETWORK | Other fees Service code 99 | 29742 NETWORK PLACE CHICAGO, IL 60673 | $63K |
| TIM LEAKE BROKER | Other fees Service code 99 | 3033 NW 63RD ST, STE 208 EAST OKLAHOMA CITY, OK 73116 | $60K |
| MULTIPLAN COMPLIMENTARY EIN 13-3068979 PPO NETWORK | Other fees Service code 99 | 3345 MICHELSON DR SUITE 200 IRVINE, CA 92612 | $8K |
| NOVANET, INC EIN 58-2106226 PPO NETWORK | Other fees Service code 99 | 3500 PARKWAY LANE SUITE 440 NORCROSS, GA 30092 | $6K |
| AMERICAN HEALTH HOLDINGS EIN 31-1368946 MEDICAL REVIEW | Other fees Service code 99 | P.O. BOX 360142 PITTSBURGH, PA 15250 | $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 | 203 | 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) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CERTUS MANAGEMENT GROUP | 203 | $598K |
| Dental | CERTUS MANAGEMENT GROUP | 203 | $598K |
| Vision | CERTUS MANAGEMENT GROUP | 203 | $598K |
| Prescription drug | CERTUS MANAGEMENT GROUP | 203 | $598K |
| Stop-loss / reinsurancereinsurance | CERTUS MANAGEMENT GROUP | 203 | $598K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.