| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | PAN-AMERICAN LIFE INSURANCE COMPANY | $32K | — | $32K | 10.00% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | ONE AMERICA | $26K | $8K | $34K | 21.23% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $4K | $17K | 12.75% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.80% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.79% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 8.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PAN-AMERICAN LIFE ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 601 POYDRAS ST NEW ORLEANS, LA 70130 | $70K |
| PAN-AMERICAN BENEFIT SOLUTIONS ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 1778 NO PLANO RD STE 310 RICHARDSON, TX 75081 | $24K |
| THE PLEXUS GROUPE LLC BROKER | Insurance brokerage commissions and fees Service code 53 | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | $16K |
| RXEDO ADMINISTRATOR | Claims processing Service code 12 | PO BOX 678586 DALLAS, TX 75081 | $111 |
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 | 426 | 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) | 426 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PAN-AMERICAN LIFE INSURANCE COMPANY | 426 | $383K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $137K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 337 | $22K |
| Life insurance | ONE AMERICA | 180 | $162K |
| Short-term disability | ONE AMERICA | 180 | $162K |
| Long-term disability | ONE AMERICA | 180 | $162K |
| Other(2 contracts, 2 carriers) | ONE AMERICA | 190 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 426 | — |
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.