| 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. | $39K | $55K | $94K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $327K |
| VAN NOY CONSULTING GROUP CONSULTING | Consulting (general) Service code 16 | 2312 PROMETHEUS COURT HENDERSON, NV 89074 | $84K |
| RXBENEFITS, INC. EIN 63-1157085 PHARMACY BENEFITS MANAGER | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | 3700 COLONNADE PKWY, STE 600 BIRMINGHAM, AL 35243 | $7K |
| ALLIANCE ADVISORS, LLC EIN 92-1454572 CONSULTING | Consulting (general); Direct payment from the plan; Consulting fees Service code 16 | — | $6K |
| UNITED OF OMAHA LIFE INSURANCE COMP EIN 47-0322111 CLAIMS PROCESSING | Claims processing Service code 12 | — | $5K |
| PRUDENTRX EIN 84-4560702 CLAIMS PROCESSING | Claims processing; Other services Service code 12 | — | $742 |
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 | 669 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 679 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 1 | $3K |
| Dental | LIBERTY DENTAL PLAN OF NEVADA, INC. | 682 | $386K |
| Vision | VISION SERVICE PLAN | 676 | $79K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 647 | $116K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 202 | $232K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE CO. | 665 | $781K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 647 | $457K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 682 | — |
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.