| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 Filed as: IMA INC | 8200 E 32ND ST NORTH WICHITA, KS 67226 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $3K | $3K | 0.75% |
| IMA, INC.3 Filed as: IMA INC | 8200 E 32ND ST NORTH WICHITA, KS 67226 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $1K | $1K | 0.74% |
| IMA, INC.3 Filed as: IMA INC | 8200 E 32ND ST NORTH WICHITA, KS 67226 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $112 | $112 | 0.38% |
| IMA, INC.3 Filed as: IMA INC | 8200 E 32ND ST NORTH WICHITA, KS 67226 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $217 | $217 | 0.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Other fees; Direct payment from the plan Service code 50 | — | $458K |
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $435K |
| ANTHEM BLUE CROSS EIN 95-4331852 | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $407K |
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 | 1,333 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPSYCH | 1,633 | $37K |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,215 | $989K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 2,488 | $205K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,629 | $425K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,631 | $177K |
| Other(3 contracts) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,631 | $483K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,488 | — |
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.