| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELYSIAN INSURANCE AGENCY3 Filed as: ELYSIAN HEALTHCARE | — | ATLANTIC COAST LIFE | — | $23K | $23K | 2.01% |
| CASEY JAMES KUGLER3 Filed as: CASEY STRUNK | — | ATLANTIC COAST LIFE | $15K | — | $15K | 1.25% |
| CONCIERGE ADMINISTRATIVE SERVICES3 | 300 SE FRANK PHILLIPS BOULEVARD SUITE 200 BARTLESVILLE, OK 74003 | CHAMPION HEALTH MINIMUM ESSENTIAL COVERAGE PLUS PLAN | $17K | — | $17K | 1.86% |
| STRUNK INSURANCE GROUP3 Filed as: THE STRUNK INSURANCE GROUP INC | 14425 NORTH 7TH STREET SUITE 102 PHOENIX, AZ 85022 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 12.90% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 WEST ERIE STREET SUITE 300 CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $413 | $413 | 1.47% |
| STRUNK INSURANCE GROUP3 Filed as: STRUNK INSURANCE GROUP INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 264.63% |
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 | 188 | 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) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 55 | $1K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 80 | $28K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 80 | $28K |
| Other(3 contracts, 3 carriers) | ATLANTIC COAST LIFE | 228 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.