| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LA PORTE AND ASSOCIATES INC3 Filed as: LA PORTE & ASSOCIATES INC | — | MODA HEALTH | $26K | — | $26K | 3.32% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 Filed as: SUPPLEMENTAL BEN SOLUTIONS INC | 9419 WEST VILLA HERMOSA PEORIA, AZ 85383 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 2.25% |
| LAPORTE & ASSOCIATES, INC3 Filed as: LAPORTE & ASSOC INC | 5515 NORTHEAST MILWAUKIE AVENUE PORTLAND, OR 97202 | STANDARD INSURANCE COMPANY | $522 | — | $522 | 0.96% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 Filed as: SUPPLEMENTAL BEN SOLUTIONS INC | 9419 WEST VILLA HERMOSA PEORIA, AZ 85383 | STANDARD INSURANCE COMPANY | $631 | — | $631 | 6.34% |
| LAPORTE & ASSOCIATES, INC3 Filed as: LAPORTE & ASSOC INC | 5515 NORTHEAST MILWAUKIE AVENUE PORTLAND, OR 97202 | STANDARD INSURANCE COMPANY | $271 | — | $271 | 2.72% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH | 103 | $781K |
| Dental | STANDARD INSURANCE COMPANY | 91 | $54K |
| Vision | STANDARD INSURANCE COMPANY | 82 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.