| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STERLING INSURANCE CONCEPTS3 | 902 E COUNTY LINE ROAD SUITE 202 LAKEWOOD, NJ 08701 | TMS RE-NATIONWIDE | $125K | — | $125K | 8.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRXINC EIN 33-0441200 PHARMACYBENEFITMANAGEMENT | Float revenue; Other fees; Claims processing; Direct payment from the plan Service code 12 | 2300 MAIN STREET IRVINE, CA 92614 | $2.4M |
| UMR,INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | POBOX 1087 WAUSAU, WI 54402 | $913K |
| STERLING INSURACE CONCEPTS INC EIN 60-0000335 BROKER | Other commissions Service code 55 | 902ECOUNTYROAD LAKEWOOD, NJ 08701 | $194K |
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 | 1,247 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | TMS RE-NATIONWIDE | 1,247 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,247 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.