| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 10 NORTH PARK DR SUITE 200 HUNT VALLEY, MD 21030 | SUN LIFE ASSURANCE COMPANY OF CANADA | $230K | $41K | $271K | 10.72% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIR SUITE 4500 HUNT VALLEY, MD 21030 | RELIASTAR LIFE INSURANCE COMPANY | $162K | $22K | $183K | 34.03% |
| AP BENEFIT ADVISORS, LLC3 | 10 NORTH PARK DR SUITE 200 HUNT VALLEY, MD 21030 | EYEMED | $10K | — | $10K | 8.14% |
| SEE ATTACHED3 Filed as: SEE ATTACHED SCH. A | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $1 | $5K | 4.60% |
| SEE ATTACHED3 Filed as: SEE ATTACHED SCH. A | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 4.82% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS CAPITAL, INC. | 10 NORTH PARK DR #200 HUNT VALLEY, MD 21030 | LEGALPLANS USA | $7K | — | $7K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF SC EIN 57-0287419 HEALTH/RX ADMIN | Contract Administrator; Claims processing Service code 12 | — | $1.6M |
| AP BENEFIT ADVISORS LLC BROKER | Claims processing; Contract Administrator Service code 12 | 10 N PARK DR #200 HUNT VALLEY, MD 21030 | $185K |
| SUN LIFE ASSURANCE COMPANY OF CA EIN 38-1082080 EAP/FMLA ADMIN | Claims processing; Contract Administrator Service code 12 | — | $151K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 DENTAL ADMIN | Claims processing; Contract Administrator Service code 12 | — | $110K |
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 | 4,071 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 340 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED | 2,996 | $118K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,071 | $2.5M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,071 | $2.5M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,071 | $2.5M |
| Other(5 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,071 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,071 | — |
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.