| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADVANCED INSURANCE SERVICES INC3 | 633 E FERNHURST DR UNIT 1501 KATY, TX 77450 | AMERITAS LIFE INSURANCE CORP | $2K | — | $2K | 10.00% |
| ADVANCED INSURANCE SERVICES INC3 | 440 COBIA DRIVE UNIT 1501 KATY, TX 77494 | NIPPON LIFE BENEFITS | $583 | — | $583 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMWINS ACCIDENT & HEALTH UNDERWRITE EIN 13-4009411 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $113K |
| BENEFIT INDEMNITY CORPORATION EIN 66-0761417 THIRD PARTY ADMIN. | Contract Administrator Service code 13 | — | $22K |
| EDISON HEALTH SOLUTIONS EIN 85-0538612 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $22K |
| PCF INSURANCE SERVICES OF THE WEST EIN 82-1368960 AGENT/AGENCY | Insurance brokerage commissions and fees Service code 53 | — | $16K |
| CIGNA EIN 84-0467907 PREFERRED PROV. NETWORK | Contract Administrator Service code 13 | — | $6K |
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 | 147 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 120 | $20K |
| Vision | AMERITAS LIFE INSURANCE CORP | 120 | $20K |
| Life insurance | NIPPON LIFE BENEFITS | 147 | $4K |
| Other | NIPPON LIFE BENEFITS | 147 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.