| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH K HALEY3 | 101 N. WACKER DRIVE SUITE 612 CHICAGO, IL 60606 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $115K | — | $115K | 10.52% |
| JOSEPH K HALEY3 | 101 N. WACKER DRIVE SUITE 612 CHICAGO, IL 60606 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $43K | — | $43K | 10.00% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS INC | 8777 N GAINEY CENTER DR. SUITE 260 SCOTTSDALE, AZ 85258 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 5.00% |
| JOSEPH K HALEY3 | 101 N. WACKER DRIVE SUITE 612 CHICAGO, IL 60606 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $38K | — | $38K | 16.00% |
| TOTALIS BENEFITS3 | 8777 N GAINEY CTR DR STE 260 SCOTTSDALE, AZ 85258 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $12K | $12K | 5.00% |
| JK HALEY & ASSOCIATES3 Filed as: JK HALEY & ASSOCIATES INC | 101 N WACKER DR STE 612 CHICAGO, IL 60606 | VISION SERVICE PLAN | $2K | — | $2K | 2.90% |
| JOSEPH K HALEY3 | 812 N WASHINGTON AVE PARK RIDGE, IL 60068 | VISION SERVICE PLAN | $1K | — | $1K | 1.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CALIFORNIA PHYSICIANS SERVICE EIN 94-0360524 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 50 BEALE ST SAN FRANCISO, CA 94105 | $311K |
| JOSEPH K HALEY BROKER | Other commissions; Insurance agents and brokers Service code 22 | 101 N. WAKER DRIVE CHICAGOL, IL 60606 | $43K |
| RX BENEFITS INC. EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $5K |
| ACCENT INSURANCE RECOVERY SOLUTIONS EIN 20-1802547 RECOVERY SVC PROVIDER | Claims processing Service code 12 | 11808 MIRACLE HILLS DRIVE OMAHA, NE 68154 | $489 |
| HEALTH MANAGEMENT SYSTEMS INC. EIN 13-2770433 RECOERY SVC PROVIDER | Claims processing Service code 12 | 5615 HIGH POINT DRIVE IRVING, TX 75038 | $87 |
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 | 522 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 426 | $433K |
| Vision | VISION SERVICE PLAN | 402 | $60K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 522 | $238K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 522 | $238K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 522 | $238K |
| Stop-loss / reinsurancereinsurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 520 | $1.1M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 522 | $238K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 522 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.