| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASCENDE, INC.3 | 2700 POST OAK BLVD, 25TH FLOOR HOUSTON, TX 77056 | HEALTH CARE SERVICE CORPORATION | $0 | $14K | $14K | 0.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $1.7M |
| CVS PHARMACY INC EIN 05-0340626 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $122K |
| HAYNESBOONE EIN 75-1312888 NONE | Legal; Direct payment from the plan Service code 29 | — | $55K |
| VISION SERVICE PLAN EIN 06-1222784 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $50K |
| THE BANK OF NY MELLON EIN 39-1669331 NONE | Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $25K |
| MCCONNELL & JONES EIN 76-0488832 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $19K |
| BLACKROCK INSTITUTIONAL TRUST CO EIN 94-3112180 NONE | Investment management fees paid directly by plan; Investment management; Direct payment from the plan Service code 28 | — | $17K |
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 | 2,471 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 332 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,803 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HEALTH CARE SERVICE CORPORATION | 7,047 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,047 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.