| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18940 N. PIMA ROAD SUITE 210 SCOTTSDALE, AZ 85255 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | — | $43K | $43K | 5.00% |
| HOLMES MURPHY & ASSOCIATES3 | P.O. BOX 441 DES MOINES, IA 50302 | STANDARD INSURANCE COMPANY | $64K | — | $64K | 13.81% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC, LLC | P.O. BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 0.28% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES, LLC-DALLAS | P.O. BOX 123042 DEPT 3042 DALLAS, TX 75312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $175 | $2K | 2.71% |
| GUS BATES INSURANCE3 Filed as: COMISKEY, GUS, HENRY | 5120 WOODWAY SUITE 6002 HOUSTON, TX 77056 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.07% |
| GUS BATES INSURANCE3 Filed as: COMISKEY KAUFMAN CONSULTING, LLC | 5120 WOODWAY SUITE 6002 HOUSTON, TX 77056 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.91% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES, MURPHY & ASSOCIATES | P.O. BOX 441 DES MOINES, IA 50302 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $165 | — | $165 | 0.28% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES,LLC-HOME OFFICE | 444 W. 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $17 | $17 | 0.03% |
| GUS BATES INSURANCE3 Filed as: COMISKEY GUS, HENRY | 5120 WOODWAY SUITE 6002 HOUSTON, TX 77056 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $19 | — | $19 | 2.19% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES,LLC-DALLAS SERIES | P.O. BOX 123042 DEPT 3042 DALLAS, TX 75312 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $12 | $3 | $15 | 1.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES EIN 41-1289245 CLAIMS PROCESSING | Other services; Claims processing Service code 12 | — | $465K |
| DELTA DENTAL EIN 94-2761537 CLAIMS PROCESSING | Claims processing Service code 12 | — | $24K |
| RX BENEFITS, INC. EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $13K |
| HOLMES MURPHY AND ASSOCS. EIN 42-0985055 BROKER | Other commissions Service code 55 | — | $6K |
| DISCOVERY BENEFITS EIN 90-0058554 CONTRACT ADMINISTRATOR | 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 | 967 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 970 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 596 | $67K |
| Life insurance | STANDARD INSURANCE COMPANY | 990 | $461K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 21 | $61K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 967 | $863K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 990 | — |
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.