| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHILD HEALTH CORP OF AMERICA3 | 6803 W 64TH ST SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $46K | $23K | $69K | 6.40% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $45K | $45K | 4.17% |
| JAMES L HALL II3 Filed as: JAMES L. HALL, II | 181 EAST 5600 SOUTH SUITE 240 SALT LAKE CITY, UT 84107 | ASSURITY LIFE INSURANCE | $7K | — | $7K | 3.24% |
| JAMES D DAVIDSON3 | 1820 E 1ST STREET SUITE 400 SANTA ANA, CA 92705 | ASSURITY LIFE INSURANCE | $7K | — | $7K | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 181 EAST 5600 SOUTH SUITE 240 SALT LAKE CITY, UT 84107 | ASSURITY LIFE INSURANCE | $6K | — | $6K | 2.85% |
| MARTIN REED COWICK3 Filed as: MARTIN COWICK | 5 PETERS POND DR. FORESTDALE, MA 02644 | ASSURITY LIFE INSURANCE | $69 | — | $69 | 0.03% |
| CHILD HEALTH CORP OF AMERICA3 | 6803 W 64TH ST SUITE 208 SHAWNEE MISSION, KS 66202 | UNITED HEALTHCARE INSURANCE COMPANY | $15K | — | $15K | 10.66% |
| CHILD HEALTH CORP OF AMERICA3 | 6803 W 64TH ST SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $2K | $2K | $4K | 8.67% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 4.00% |
No Schedule C service providers reported on this filing.
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 | 1,730 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,733 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 1,921 | $144K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,554 | $1.3M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 2,554 | $1.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,554 | $1.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 1,836 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,554 | — |
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.