| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES, INC | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | PACE UNDERWRITERS | $11K | — | $11K | 5.00% |
| NELSON FINANCIAL GROUP LLC3 Filed as: NELSON FINANCIAL SERVICES | 4TH AVENUE WEST DICKINSON, ND 58601 | PACE UNDERWRITERS | $6K | — | $6K | 2.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACE UNDERWRITERS EIN 81-4888426 STOP LOSS INS. CARRIER | Other fees Service code 99 | 4120 INTERNATIONAL PARKWAY STE 2200 CARROLLTON, TX 75007 | $217K |
| GROUP BENEFIT SERVICES, INC. EIN 43-1770779 BROKER | Other fees Service code 99 | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | $11K |
| GROUP BENEFIT SERVICES, INC EIN 43-1770779 THIRD PARTY ADMINISTRATOR | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1736 E SUNSHINE ST STE 200 SPRINGFIELD, MO 65804 | $10K |
| PHCS EIN 13-3068979 PPO NETWORK | Other fees Service code 99 | 3345 MICHELSON DR STE 200 IRVINE, CA 92612 | $7K |
| NELSON FINANCIAL SERVICES EIN 50-2660549 BROKER | Other fees Service code 99 | 4TH AVENUE WEST DICKINSON, ND 58601 | $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 | 31 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 31 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACE UNDERWRITERS | 3 | $217K |
| Prescription drug | PACE UNDERWRITERS | 3 | $217K |
| Stop-loss / reinsurancereinsurance | PACE UNDERWRITERS | 3 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.