| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DECISELY INSURANCE SERVICES INC3 Filed as: DECISELY INSURANCE SERVICES INC. | 10800 ALPHARETTA HWY, SUITE 208 #784 ROSWELL, GA 30076 | ANTHEM LIFE INSURANCE COMPANY | $92K | $0 | $92K | 77.33% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | ANTHEM LIFE INSURANCE COMPANY | $56K | $0 | $56K | 47.43% |
| DECISELY INSURANCE SERVICES INC3 Filed as: DECISELY INSURANCE SERVICES LLC | PO BOX 8064 CAROL STREAM, IL 60197 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.09% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $529 | $0 | $529 | 1.27% |
| DECISELY INSURANCE SERVICES INC3 Filed as: DECISELY INSURANCE SERVICES INC. | 3700 MANSELL RD., STE. 525 ALPHARETTA, GA 30022 | VISION SERVICE PLAN | $110 | $0 | $110 | 0.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SUNLIFE ASSURANCE COMPANY OF CANADA EIN 38-1082080 NONE | Other fees; Claims processing Service code 12 | — | $164K |
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 | 289 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 450 | $3.1M |
| Vision | VISION SERVICE PLAN | 239 | $42K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 289 | $119K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 289 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 450 | — |
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."
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.