| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BEV CAP MANAGEMENT LLC3 | 120 W VIRGINIA ST STE 200 MCKINNEY, TX 75069 | HARTFORD LIFE AND ACCIDENT | $14K | — | $14K | 24.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORNERSTONE/IMA EIN 20-2557329 CONSULTANT/MANAGEMENT | Consulting (general) Service code 16 | — | $54K |
| AMERIBEN / IEC GROUP EIN 82-0497661 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | PO BOX 7186 BOISE, ID 83707 | $12K |
| JOHNSON, MILLER & CO, CPAS EIN 85-0214336 ACCOUNTANT | Accounting (including auditing) Service code 10 | 2626 JBS PARKWAY, A-200 ODESSA, TX 79761 | $0 |
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 | 465 | 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) | 465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BERKLEY LIFE AND HEALTH INSURANCE CO | 0 | $447K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 465 | $56K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 465 | $56K |
| Prescription drug | BERKLEY LIFE AND HEALTH INSURANCE CO | 0 | $447K |
| Other | AIG BENEFIT SOLUTIONS | 405 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 465 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.