| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT DONOGHUE3 | 2 PIERCE PLACE 21ST FL ITASCA, IL 60143 | MONY LIFE INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 18.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Other fees; Claims processing; Direct payment from the plan; Float revenue Service code 12 | — | $220K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $80K |
| GALLAGHER BENEFIT SERVICES INC EIN 36-4291971 BROKER | Other commissions Service code 55 | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | $11K |
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 | 103 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | MONY LIFE INSURANCE COMPANY OF AMERICA | 560 | $136K |
| Vision | MONY LIFE INSURANCE COMPANY OF AMERICA | 560 | $136K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 560 | $136K |
| Long-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 560 | $136K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 95 | $252K |
| Other | MONY LIFE INSURANCE COMPANY OF AMERICA | 560 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 560 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.