| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE CO. | $249 | — | $249 | 14.98% |
| TRG INSURANCE SERVICES5 | P.O. BOX 743376 LOS ANGELES, CA 90074 | TRANSAMERICA INSURANCE CO. | $105 | — | $105 | 6.32% |
| WEB TPA5 | 8500 FREEPORT PKWY S IRVING, TX 75063 | TRANSAMERICA INSURANCE CO. | $84 | — | $84 | 5.05% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | HEARTLAND FIDELITY INSURANCE COMPANY | $67 | — | $67 | 7.02% |
| TRG INSURANCE SERVICES5 | P.O. BOX 743376 LOS ANGELES, CA 90074 | HEARTLAND FIDELITY INSURANCE COMPANY | $12 | — | $12 | 1.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INC. CO. EIN 13-5581829 NONE | Claims processing; Contract Administrator Service code 12 | — | $60K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Contract Administrator Service code 12 | — | $16K |
| BLUE SHIELD OF CALIFORNIA EIN 94-6077403 NONE | Claims processing; Employee (plan) Service code 12 | — | $0 |
| BROKERAGE CONCEPTS EIN 11-3667763 NONE | Claims processing Service code 12 | — | $0 |
| INTEGRO USA, INC. EIN 20-2600995 NONE | Custodial (securities) Service code 19 | — | $0 |
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 | 1,183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA INSURANCE CO. | 1 | $2K |
| Prescription drug | HEARTLAND FIDELITY INSURANCE COMPANY | 1 | $955 |
| Stop-loss / reinsurancereinsurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INS. CO. | 1,183 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,183 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.