| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITMALL3 | 2111 EAST HIGHLAND AVENUE SUITE B210 PHOENIX, AZ 85016 | STANDARD LIFE & ACCIDENT INSURANCE COMPANY | $16K | — | $16K | 5.00% |
| SHELLEY BURT3 Filed as: SHELLEY BURT NAX | 7105 OTTAWA ROAD NORTHEAST ALBUQUERQUE, NM 87110 | COMPANION LIFE INSURANCE COMPANY DENTAL PLAN | $3K | — | $3K | 3.37% |
| BURT SHELLEY B3 | 7105 OTTAWA ROAD NORTHEAST ALBUQUERQUE, NM 87110 | KC LIFE | $2K | — | $2K | 10.46% |
| SHELLEY BURT3 | 5801 OSUNA ROAD NORTHEAST SUITE 110 ALBUQUERQUE, NM 87109 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 14.00% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPANION LIFE INSURANCE COMPANY DENTAL PLAN | 177 | $77K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 182 | $16K |
| Life insurance | KC LIFE | 219 | $21K |
| Long-term disability | KC LIFE | 219 | $21K |
| Stop-loss / reinsurancereinsurance | STANDARD LIFE & ACCIDENT INSURANCE COMPANY | 155 | $314K |
| Other | KC LIFE | 219 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.