| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVATIVE INSURANCE SOLUTION LLC3 | 135 CORPORATE CENTER DRIVE STE 551 SCOTT DEPOT, WV 255607864 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | — | $16K | 7.25% |
| KEY BENEFIT ADMINISTRATORS, INC5 Filed as: KEY BENEFIT ADMINISTRATORS, INC. | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | QBE INSURANCE CORPORATION | $2K | — | $2K | 10.00% |
| INNOVATIVE INSURANCE SOLUTION LLC3 | 135 CORPORATE CENTER DRIVE STE 551 SCOTT DEPOT, WV 255607864 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 21.19% |
| INNOVATIVE INSURANCE SOLUTION LLC3 | 135 CORPORATE CENTER DRIVE STE 551 SCOTT DEPOT, WV 255607864 | METROPOLITAN LIFE INSURANCE COMPANY | $533 | — | $533 | 19.12% |
| INNOVATIVE INSURANCE SOLUTION LLC3 | 135 CORPORATE CENTER DRIVE STE 551 SCOTT DEPOT, WV 255607864 | METROPOLITAN LIFE INSURANCE COMPANY | -$40 | — | -$40 | -3.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS INC EIN 35-1450364 N/A | Plan Administrator Service code 14 | — | $59K |
| GWH CIGNA PPO EIN 84-0467907 N/A | Contract Administrator Service code 13 | — | $27K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 N/A | Contract Administrator Service code 13 | — | $17K |
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 | 113 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 23 | $9K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 319 | $224K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 319 | $224K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 319 | $224K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 319 | $224K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 319 | $224K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 319 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.