| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHARLES MONEY3 Filed as: CHARLES MISASI | PO BOX 2568 FRISCO, TX 75034 | CAREINGTON | $434 | — | $434 | 12.12% |
| MWL3 | PO BOX 14067 JACKSON, MS 39236 | CAREINGTON | $180 | — | $180 | 5.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH SERVICES & BENEFIT ADMINISTR EIN 94-3089465 NONE | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Participant communication; Contract Administrator; Copying and duplicating Service code 10 | — | $128K |
| U.A. LOCAL 159 EIN 94-0944925 SPONSORING LOCAL | Direct payment from the plan; Plan Administrator Service code 14 | — | $99K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $63K |
| LINDQUIST LLP EIN 52-2385296 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $40K |
| BANK OF AMERICA EIN 94-1687665 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $13K |
| KRAW & KRAW LAW GROUP EIN 77-0171216 NONE | Copying and duplicating; Legal; Direct payment from the plan Service code 29 | — | $11K |
| ALAN D. BILLER & ASSOCIATES EIN 94-2854958 NONE | Consulting (pension); Direct payment from the plan; Investment advisory (plan) Service code 17 | — | $6K |
| WEX HEALTH NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 82 HOPMEADOW STREET SIMSBURY, CT 06089 | $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 | 231 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 139 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 167 | $1.6M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 642 | $495K |
| Vision | VISION SERVICE PLAN | 338 | $44K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $24K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 167 | $1.6M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 694 | — |
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.