| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADP INC3 | PO BOX 830272 PHILADELPHIA, PA 19182 | STANDARD INSURANCE COMPANY | — | $3K | $3K | 4.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 2.73% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS LLC | 1 BEACON STREET SUITE 17100 BOSTON, MA 02108 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 2.46% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NY INC | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $966 | — | $966 | 1.23% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 10.03% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS LLC | 1 BEACON STREET SUITE 17100 BOSTON, MA 02108 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 5.02% |
| ADP INC3 | PO BOX 830272 PHILADELPHIA, PA 19182 | STANDARD INSURANCE COMPANY | — | $2K | $2K | 4.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NY INC | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 2.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS LLC | 1 BEACON STREET SUITE 17100 BOSTON, MA 02108 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 4.88% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NY INC | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $941 | — | $941 | 2.44% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS LLC | 1 BEACON STREET SUITE 17100 BOSTON, MA 02108 | STANDARD INSURANCE COMPANY | $773 | — | $773 | 4.78% |
| ADP INC3 | PO BOX 830272 PHILADELPHIA, PA 19182 | STANDARD INSURANCE COMPANY | — | $646 | $646 | 4.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NY INC | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $386 | — | $386 | 2.39% |
| ADP INC3 | PO BOX 830272 PHILADELPHIA, PA 19182 | STANDARD INSURANCE COMPANY | — | $510 | $510 | 4.12% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS LLC | 1 BEACON STREET SUITE 17100 BOSTON, MA 02108 | STANDARD INSURANCE COMPANY | $296 | — | $296 | 2.39% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | STANDARD INSURANCE COMPANY | $290 | — | $290 | 2.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NY INC | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $148 | — | $148 | 1.20% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 166 | $381K |
| Dental | STANDARD INSURANCE COMPANY | 114 | $79K |
| Vision | STANDARD INSURANCE COMPANY | 123 | $12K |
| Life insurance | STANDARD INSURANCE COMPANY | 142 | $47K |
| Short-term disability | STANDARD INSURANCE COMPANY | 107 | $16K |
| Long-term disability | STANDARD INSURANCE COMPANY | 142 | $39K |
| Stop-loss / reinsurancereinsurance | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 166 | $381K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.