| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $94K | $15K | $109K | 14.68% |
| CENTERED INSURANCE SOLUTIONS, INC.3 Filed as: CENTERED INSURANCE SOLUTIONS INC | 1100 FLYNN RD UNIT 102 CAMARILLO, CA 93012 | KAISER FOUNDATION HEALTH PLAN INC | $21K | $12K | $32K | 7.17% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES I | 32440 AGOURA RD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 1.67% |
| EBENCONCEPTS COMPANY3 | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | STARMOUNT LIFE INSURANCE COMPANY | $31K | $6K | $37K | 13.72% |
| EBENCONCEPTS COMPANY3 | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | UNUM INSURANCE COMPANY | $6K | $1K | $7K | 16.81% |
| EBENCONCEPTS COMPANY3 | 15305 DALLAS PARWAY STE 800 ADDISON, TX 75001 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $411 | $2K | 21.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Consulting fees; Consulting (general) Service code 16 | — | $36K |
| FLORES AND ASSOCIATES EIN 56-1542307 FSA ADMINISTRATOR | Other insurance fees and expenses; Insurance services; Account maintenance fees Service code 23 | — | $3K |
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 | 696 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 696 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 372 | $3.2M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 438 | $268K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 438 | $268K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 696 | $742K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 696 | $752K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 696 | $742K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 372 | $2.7M |
| Other(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 696 | $3.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 696 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.