| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SPOTLITE INC3 | 216 WEST OHIO STREET, SUITE 400 CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 1.23% |
| BSG GROUP ALLIANCE INC3 Filed as: BSG GROUP ALLIANCE, INC. | UNKNOWN LAS VEGAS, NV 89118 | TRIPLE S SALUD, INC. | $18K | — | $18K | 5.00% |
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 | 2,668 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 179 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,847 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE S SALUD, INC. | 74 | $351K |
| Dental | TRIPLE S SALUD, INC. | 74 | $351K |
| Vision | EYEMED VISION CARE | 4,507 | $272K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 5,089 | $1.2M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 5,089 | $1.2M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 5,089 | $1.2M |
| Prescription drug | TRIPLE S SALUD, INC. | 74 | $351K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,089 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,089 | — |
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.