| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FLEXIBLE BENEFITS CORPORATION3 | PO BOX 1894 TACOMA, WA 98401 | QBE INSURANCE | $64K | $0 | $64K | 17.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | SUITE 700 1145 BROADWAY PLAZA TACOMA, WA 98402 | PRUDENTIAL INSURANCE CO OF AMERICA | $6K | — | $6K | 7.89% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE CO OF AMERICA | $0 | $125 | $125 | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTEED PLANS SERVICE CORPORATION EIN 91-0780588 NONE | Contract Administrator Service code 13 | — | $87K |
| FIRST CHOICE HEALTH NETWORK EIN 91-1272766 NONE | Other services Service code 49 | — | $15K |
| BROWN & BROWN OF WASHINGTON INC EIN 91-1622053 NONE | Insurance agents and brokers Service code 22 | — | $7K |
| AMERICAN HEALTH HOLDING EIN 31-1367946 NONE | Other services Service code 49 | — | $5K |
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 | 295 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE CO OF AMERICA | 362 | $78K |
| Long-term disability | PRUDENTIAL INSURANCE CO OF AMERICA | 362 | $78K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 292 | $375K |
| Other | PRUDENTIAL INSURANCE CO OF AMERICA | 362 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.
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.