| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VXTRA PARTNERS3 | 2700 CUMBERLAND PARKWAY SUITE 140 ATLANTA, GA 30339 | HCC LIFE INSURANCE COMPANY | $18K | $0 | $18K | 2.00% |
| GBC BENEFITS LTD3 Filed as: GBC BENEFITS, LTD | 3221 COLLINSWORTH STREET FORT WORTH, TX 76107 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $52K | $0 | $52K | 10.78% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $89 | $89 | 0.02% |
| GBC BENEFITS LTD3 | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | STANDARD INSURANCE COMPANY | $13K | $0 | $13K | 11.00% |
| GBC BENEFITS LTD3 | 3221 COLLINSWORTH ST FORT WORTH, TX 76107 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 13.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $233K |
| VXTRA PARTNERS EIN 02-0677823 BROKER | Other commissions Service code 55 | 2700 CUMBERLAND PKWY STE 140 ATLANTA, GA 30339 | $85K |
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 | 276 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 162 | $120K |
| Vision | STANDARD INSURANCE COMPANY | 143 | $19K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 280 | $483K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 280 | $483K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 276 | $898K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 280 | $483K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.