| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERITAS RISK SERVICES3 | 1900 SPRING ROAD, SUITE 530 OAKBROOK, IL 60523 | HUMANA INSURANCE COMPANY | $13K | — | $13K | 3.01% |
| VERITAS RISK SERVICES3 | 1900 SPRING ROAD, SUITE 530 OAK BROOK, IL 605231477 | VISION SERVICE PLAN | $243 | — | $243 | 17.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFE INSURANCE COMPANY OF N.A. EIN 23-1503749 NONE | Claims processing; Insurance brokerage commissions and fees; Insurance services; Direct payment from the plan Service code 12 | — | $987K |
| HCSC, MUTUAL LEGAL RESERVE CO. EIN 36-1236610 NONE | Claims processing; Insurance brokerage commissions and fees; Direct payment from the plan Service code 12 | — | $434K |
| HUMANA INSURANCE COMPANY EIN 39-1263473 NONE | Direct payment from the plan; Claims processing; Insurance brokerage commissions and fees; Insurance services Service code 12 | — | $433K |
| HIGHMARK CAPITAL MANAGEMENT, INC. EIN 23-1294723 NONE | Investment advisory (plan); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management; Direct payment from the plan Service code 27 | — | $192K |
| CHARLES SCHWAB EIN 34-1479833 NONE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $39K |
| VISION SERVICE PLAN EIN 20-0891619 NONE | Insurance services; Direct payment from the plan; Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 890 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 240 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 221 | $442K |
| Vision | VISION SERVICE PLAN | 7 | $1K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,005 | $1.1M |
| Prescription drug | HUMANA INSURANCE COMPANY | 221 | $442K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,005 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.