| 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 | $29K | — | $29K | 3.00% |
| IBS INC3 | PO BOX 396 KAUKAUNA, WI 54130 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | — | $11K | 3.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHWEST SERVICE ADMINISTRATORS EIN 86-0785790 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $10.2M |
| BLUECROSS BLUESHIELD OF AZ., INC. EIN 86-0004538 NONE | Direct payment from the plan; Other fees Service code 50 | — | $2.5M |
| AMERICAN HEALTH GROUP NONE | Other fees; Direct payment from the plan Service code 50 | 2152 S VINEYARD STE 103 MESA, AZ 85210 | $534K |
| UNITED HEALTHCARE NONE | Other fees; Direct payment from the plan Service code 50 | 333 W VINE ST STE 500 LEXINGTON, KY 40507 | $517K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $322K |
| ACTIVE RADAR NONE | Other fees; Direct payment from the plan Service code 50 | 2 RICHMOND SQUARE STE 110 PROVIDENCE, RI 02906 | $303K |
| NATIONAL INVESTMENT SERVICES, INC. EIN 80-0169636 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $293K |
| HORIZON ACTUARIAL SERVICES NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | 420 EXCHANGE STE 260 IRVINE, CA 92602 | $204K |
| OPTUM RX NONE | Direct payment from the plan; Other fees Service code 50 | 2300 MAIN ST IRVINE, CA 92614 | $193K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | — | $185K |
| TELADOC, INC. NONE | Other fees; Direct payment from the plan Service code 50 | 1945 LAKEPOINTE DR LEWISVILLE, TX 75057 | $162K |
| VISION SERVICE PLAN EIN 23-7293853 NONE | Direct payment from the plan; Other fees Service code 50 | — | $135K |
| MCCRACKEN STEMERMAN & HOLSBERRY LLP EIN 94-1709555 NONE | Legal; Direct payment from the plan Service code 29 | — | $128K |
| AVNEW HEALTH, LLC. EIN 45-5544948 NONE | Direct payment from the plan; Other fees Service code 50 | — | $103K |
| BLUECROSS BLUESHIELD OF IL., INC. NONE | Other fees; Direct payment from the plan Service code 50 | 300 E RANDOLPH ST CHICAGO, IL 60601 | $96K |
| CHARTWELL INVESTMENT PARTNERS NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1205 WESTLAKES DR STE 100 BERWYN, PA 19312 | $82K |
| HEALTH MANAGEMENT CONCEPTS, INC. EIN 75-3189468 NONE | Direct payment from the plan; Other fees Service code 50 | — | $68K |
| REINHART BOERNER VAN DEUREN, S.C. EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $68K |
| UNITED CONCORDIA, INC EIN 95-4146179 NONE | Direct payment from the plan; Other fees Service code 50 | — | $67K |
| BANK OF AMERICA EIN 86-0005300 NONE | Direct payment from the plan; Other fees Service code 50 | — | $33K |
| THE NORTHERN TRUST EIN 39-1561860 NONE | Float revenue; Direct payment from the plan; Custodial (securities); Other services Service code 19 | — | $15K |
| NEW ENGLAND PENSION CONSULTANTS EIN 04-2927339 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $15K |
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 | 17,079 | 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) | 17,079 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 3 carriers) | ALPHA DENTAL OF ARIZONA, INC. | 2,401 | $367K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 41,095 | $303K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 16,281 | $983K |
| Other(2 contracts, 2 carriers) | HEALTH MANAGEMENT CONCEPTS,INC. | 41,095 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 41,095 | — |
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.