| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEPHENS INSURANCE LLC3 Filed as: STEPHENS INSURNACE LLC | 111 CENTER ST STE 1410 LITTLE ROCK, AR 72201 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 5.70% |
| AVANT SPECIALTY BENEFITS LLC3 | PO BOX 441 DES MOINES, IA 50302 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 2.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE P EIN 58-1638390 CARRIER | Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $829K |
| INGENIORX, INC. EIN 82-3062245 PBM | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue Service code 12 | — | $0 |
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 | 659 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 659 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 955 | $1.5M |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 955 | $1.5M |
| Short-term disability | STANDARD INSURANCE COMPANY | 659 | $120K |
| Long-term disability | STANDARD INSURANCE COMPANY | 659 | $120K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 955 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 955 | — |
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.