| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 | 940 ADAMS ST STE G BENICIA, CA 94510 | HCC LIFE INSURANCE COMPANY | $69K | — | $69K | 5.00% |
| GORDON WILLIAMSON3 | PO BOX 2579 APPLETON, WI 549122579 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 2.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHWEST SERVICE ADMINISTRATORS EIN 86-0785790 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $6.7M |
| BLUECROSS BLUESHIELD OF AZ., INC. EIN 86-0004538 NONE | Other fees; Direct payment from the plan Service code 50 | — | $1.8M |
| CIGNA HEALTH & LIFE INSURANCE CO. NONE | Direct payment from the plan; Other fees Service code 50 | 11001 N BLACK CYN HWY STE 300 PHOENIX, AZ 85029 | $1.7M |
| IHN, INC. EIN 35-2041388 NONE | Other fees; Direct payment from the plan Service code 50 | — | $817K |
| CATAMARAN, INC. EIN 98-0167449 NONE | Direct payment from the plan; Other fees Service code 50 | — | $462K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $303K |
| SWH 2015 HOLDINGS, INC. NONE | Other fees; Direct payment from the plan Service code 50 | 105 DECKER CT STE 475 IRVING, TX 75062 | $302K |
| AMERICAN HEALTH GROUP NONE | Other fees; Direct payment from the plan Service code 50 | 2152 S VINEYARD STE 103 MESA, AZ 85210 | $261K |
| HEALTH MANAGEMENT CONCEPTS, INC. EIN 75-3189468 NONE | Other fees; Direct payment from the plan Service code 50 | — | $217K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $206K |
| CREWS MACQUARRIE & ASSOCIATES, INC. NONE | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | 2855 MICHELLE DR STE 100 IRVINE, CA 92606 | $171K |
| TELADOC, INC. NONE | Direct payment from the plan; Other fees Service code 50 | 1945 LAKEPOINTE DR LEWISVILLE, TX 75057 | $161K |
| VISION SERVICE PLAN EIN 23-7293853 NONE | Direct payment from the plan; Other fees Service code 50 | — | $139K |
| TOTAL DENTAL ADMINISTRATORS NONE | Direct payment from the plan; Other fees Service code 50 | 2111 E HIGHLAND AVE STE 250 PHOENIX, AZ 85016 | $110K |
| MCCRACKEN STEMERMAN & HOLSBERRY LLP EIN 94-1709555 NONE | Legal; Direct payment from the plan Service code 29 | — | $105K |
| REINHART BOERNER VAN DEUREN, S.C. EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $94K |
| NATIONAL INVESTMENT SERVICES, INC. EIN 80-0169636 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $73K |
| BANK OF AMERICA EIN 86-0005300 NONE | Other fees; Direct payment from the plan Service code 50 | — | $67K |
| UNITED CONCORDIA, INC EIN 95-4146179 NONE | Other fees; Direct payment from the plan Service code 50 | — | $66K |
| CONNECTICUT GENERAL LIFE INS. CO. NONE | Other fees; Direct payment from the plan Service code 50 | PO BOX 3904 CINCINNATI, OH 45264 | $54K |
| THE SEGAL COMPANY, WESTERN STATES EIN 94-1503999 NONE | Consulting fees; Direct payment from the plan Service code 50 | — | $24K |
| NEW ENGLAND PENSION CONSULTANTS EIN 04-2927339 NONE | Other fees; Investment advisory (plan) Service code 27 | — | $15K |
| FRANK STEGMAN NONE | Trustee (individual); Direct payment from the plan Service code 20 | 2550 W UNION HILLS DR STE 290 PHOENIX, AZ 85027 | $5K |
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 | 17,525 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 17,525 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 1,371 | $484K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 41,308 | $325K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 16,438 | $1.4M |
| Other(3 contracts, 3 carriers) | HEALTH MANAGEMENT CONCEPTS,INC. | 41,308 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 41,308 | — |
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.