| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | SYMETRA LIFE INSURANCE COMPANY | — | $48K | $48K | 3.75% |
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | SYMETRA LIFE INSURANCE COMPANY | — | $8K | $8K | 0.60% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINANCIAL AND I | 28470 AVENUE STANFORD STE 300 VALENCIA, CA 91355 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $43K | $10K | $53K | 6.17% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINANCIAL AND I | 28470 AVENUE STANFORD STE 300 VALENCIA, CA 91355 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $23K | — | $23K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF TEXAS EIN 36-1236610 CONTRACT ADMIN MED | Contract Administrator Service code 13 | — | $1.6M |
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 NONE | Claims processing Service code 12 | — | $100K |
| MATRIX PAYROLL SERVICES, INC. EIN 77-0246850 NONE | Claims processing Service code 12 | — | $3K |
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 | 3,050 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,062 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 3,003 | $428K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 3,050 | $855K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,031 | $457K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 2,364 | $1.3M |
| Other | MAGELLAN HEALTHCARE | 3,338 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,338 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.