| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAINOS PARTNERS, INC.3 Filed as: KAINOS PARTNERS INC | 16545 VILLAGE DR. BLDG. B JERSEY VILLAGE, TX 77040 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | $728 | $15K | — |
| ISM INSURANCE INC3 Filed as: ISM ISN INC | 1316 N UNION ST. WILMINGTON, DE 198062534 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | — |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ARIZONA, LLC | 4544 CAMP LOWELL DR. STE. 110 TUSCON, AZ 857121334 | PRINCIPAL LIFE INSURANCE COMPANY | $742 | — | $742 | — |
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 | 105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 269 | $0 |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 269 | $0 |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 269 | $0 |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 269 | $0 |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 269 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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.