| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | EXPRESS SCRIPTS INC | $8K | — | $8K | 3.40% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 1801 K STREET NW SUITE 200 WASHINGTON, DC 20006 | EXPRESS SCRIPTS INC | $5K | — | $5K | 1.99% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INS. CO. MEDICARE SUPPLEMENT | $22K | — | $22K | 11.76% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 1801 K STREET NW SUITE 200 WASHINGTON, DC 20006 | UNITED AMERICAN INS. CO. MEDICARE SUPPLEMENT | $11K | — | $11K | 5.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AON CONSULTING EIN 22-2232264 NONE | Actuarial Service code 11 | — | $106K |
| MCCONNELL & JONES, LLP EIN 76-0488832 NONE | Accounting (including auditing) Service code 10 | — | $62K |
| AMWINS EIN 05-0461576 NONE | Contract Administrator Service code 13 | — | $47K |
| LOCKTON EIN 20-3354970 NONE | Insurance agents and brokers Service code 22 | — | $37K |
| NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $9K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 105 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EXPRESS SCRIPTS INC | 82 | $432K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 82 | — |
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.