| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMPUSYS INSURANCE SERVICES INC.3 | 3857 BIRCH ST #404 NEWPORT BEACH, CA 92660 | HEALTH NET | $39K | — | $39K | 2.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | — | DELTA DENTAL INSURANCE COMPANY | $27K | — | $27K | 2.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSHPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $40K | — | $40K | 3.79% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE 785439 | PO BOX 8299 DB EB OPERATING ACCOUNT PASADENA, CA 911098299 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | — | $19K | 1.83% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE 785439 | 1120 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $44K | — | $44K | 5.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 911098299 | VISION SERVICE PLAN | $22K | — | $22K | 6.16% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSHPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 4.04% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALIANT INSURANCE SERVICE 785439 | PO BOX 8299 DB EB OPERATING ACCOUNT PASADENA, CA 911098299 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 1.82% |
| COMPUSYS INSURANCE SERVICES INC.3 Filed as: COMPUSYS INSURANCE SERVICES, INC | 3857 BIRCH STREET SUITE 404 NEWPORT BEACH, CA 92660 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 2.80% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6TH DIRECT BILL DEPARTMENT SAN DIEGO, CA 921018156 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $45 | $20K | 16.13% |
| BSC AGENCY LLC3 | 1025 ASHWORTH RD STE 101 WEST DES MOINES, IA 502653542 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 3.22% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.81% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | — | TRIPLE S SALUD, INC. | $6K | — | $6K | 5.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6TH DIRECT BILL DEPARTMENT SAN DIEGO, CA 92101 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $45 | $19K | 15.43% |
| BSC AGENCY LLC3 | 1025 ASHWORTH RD STE 101 WEST DES MOINES, IA 502653542 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 3.08% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.75% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6TH DIRECT BILL DEPARTMENT SAN DIEGO, CA 921018156 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $45 | $17K | 15.38% |
| BSC AGENCY LLC3 | 1025 ASHWORTH RD STE 101 WEST DES MOINES, IA 502653542 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 3.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.76% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | DB-EB OPERATING ACCOUNT PO BOX 8299 PASADENA, CA 91109 | METLIFE LEGAL PLANS | $4K | — | $4K | 5.83% |
| BUSINESSOLVER.COM, INC.3 | 1025 ASHWORTH ROAD WEST DES MOINES, IA 50265 | METLIFE LEGAL PLANS | — | $594 | $594 | 0.98% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | METLIFE LEGAL PLANS | — | $551 | $551 | 0.91% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 3600 N CAPITAL PF TEXAS HWY SUITE B-200 AUSTIN, TX 78746 | METLIFE LEGAL PLANS | — | $97 | $97 | 0.16% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 770565306 | METLIFE LEGAL PLANS | — | $5 | $5 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST 6TH FLOOR SAN DIEGO, CA 92102 | FOUR EVER LIFE INS CO. | $274 | $18 | $292 | 15.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE EIN 58-1638390 CLAIMS PROCESSING | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Other fees; Contract Administrator Service code 12 | — | $2.3M |
| CATAPULT HEALTH PA EIN 83-2193832 OTHER FEES | Claims processing Service code 12 | — | $224K |
| LIFE INS COMPANY OF NORTH AMERICA EIN 23-1503749 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $45K |
| BUSINESSOLVER EIN 42-1503807 FLEX SERVICES PEPM | Other services Service code 49 | — | $24K |
| ALLIANT INSURANCE SERVICES INC CLAIMS PROCESSING | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 701 B ST FL 6 SAN DIEGO, CA 92101 | $17K |
| SIMPLE THERAPY INC. EIN 46-5571185 VENDOR | Contract Administrator; Foreign entity (e.g., an agent or broker, bank, insurance company, etc. not operating within jurisdictional boundaries of the United States); Float revenue Service code 13 | — | $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 | 3,224 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HEALTH NET | 1,827 | $2.4M |
| Dental(3 contracts, 3 carriers) | DELTA DENTAL INSURANCE COMPANY | 2,254 | $1.8M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 2,117 | $667K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,398 | $1.1M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,630 | $886K |
| Prescription drug | TRIPLE S SALUD, INC. | 17 | $125K |
| Other(7 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,361 | $821K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,398 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.