| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALTERNATIVE RISK SOLUTIONS LLC3 Filed as: ALTERNATIVE RISK SOLUTIONS | 101 2ND STREET, SUITE 100 PETALUMA, CA 94952 | RELIASTAR LIFE INSURANCE CO. | $28K | $39K | $66K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $715K |
| CVS HEALTH EIN 05-0340626 PHARMACY BENEFITS MANAGER | Claims processing; Other services Service code 12 | — | $80K |
| TERRY W VAN NOY EIN 55-0747859 CONSULTING | Consulting (general) Service code 16 | — | $77K |
| PRUDENT RX EIN 84-4560702 CLAIMS PROCESSING | Other services; Claims processing Service code 12 | — | $43K |
| LIBERTY DENTAL PLAN OF NEVADA, INC. EIN 26-0424586 CLAIMS PROCESSING | Claims processing; Other services Service code 12 | — | $29K |
| SMITH CONSULTING GROUP INC. EIN 81-0579832 CONSULTING | Consulting (general) Service code 16 | — | $26K |
| VISION SERVICE PLAN EIN 23-7089668 CLAIMS PROCESSING | Claims processing Service code 12 | — | $16K |
| UNITED OF OMAHA LIFE INSURANCE COMP EIN 47-0322111 CLAIMS PROCESSING | Claims processing Service code 12 | — | $12K |
| WIPFLI LLP EIN 39-0758449 OUTSIDE AUDITOR | Accounting (including auditing) Service code 10 | — | $12K |
| RXBENEFITS EIN 63-1157085 PHARMACY BENEFITS MANAGER | Other fees; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $6K |
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 | 507 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 507 | $3K |
| Dental(2 contracts) | LIBERTY DENTAL PLAN OF NEVADA, INC. | 1,963 | $448K |
| Vision | VISION SERVICE PLAN | 535 | $55K |
| Life insurance(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,630 | $657K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,256 | $403K |
| Prescription drug | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 386 | $854K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE CO. | 518 | $552K |
| Other(7 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,766 | $275K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,256 | — |
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."
No prospect flags tripped on this filing.