| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WA, INC. | — | VISION SERVICE PLAN | $620 | — | $620 | 8.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON, INC. | — | SUN LIFE ASSURANCE COMPANY OF CANADA | $583 | — | $583 | 14.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON, INC. | — | MAGELLAN HEALTHCARE | $326 | — | $326 | 11.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTEED PLAN SERVICE CORP EIN 91-0780588 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $34K |
| BROWN & BROWN OF WASHINGTON EIN 91-1622053 INSURANCE BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $28K |
| MULTIPLAN EIN 95-3778850 NONE | Other services Service code 49 | — | $10K |
| GUARDIAN EIN 13-5123390 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 | 115 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 104 | $8K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 118 | $4K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE OF COLUMBIA, SC | 133 | $146K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 118 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.