| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GROUP,LLC | 701 B ST FL 6 SAN DIEGO, CA 92101 | RELIASTAR LIFE INSURANCE COMPANY | — | $166K | $166K | 6.00% |
| RINGMASTER INSURANCE AGENCY LLC3 | 5200 TOWN CENTER CIR STE 540 BOCA RATON, FL 33486 | RELIASTAR LIFE INSURANCE COMPANY | — | $1K | $1K | 0.04% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $26K | — | $26K | 1.53% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1501 REEDSDALE ST SUITE 3005 PITTSBURGH, PA 15233 | SUN LIFE ASSURANCE COMPANY OF CANADA | $58K | — | $58K | 3.40% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $50K | $50K | 2.94% |
| ALLIANT INSURANCE SERVICES, INC.3 | 16000 N DALLAS PARKWAY STE 850 DALLAS, TX 75248 | DELTA DENTAL OF OHIO | $15K | — | $15K | 0.98% |
| ALLIANT INSURANCE SERVICES, INC.3 | EXIE IZAGUIRRE AUSTIN, TX 78746 | DELTA DENTAL OF OHIO | $13K | — | $13K | 0.86% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT EMPLOYEE BENEFITS - GA | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | EYEMED VISION CARE | $14K | — | $14K | 5.00% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | — | $432 | $432 | 1.58% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS & BLUESHIELD OF WISCONSIN EIN 39-0138065 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $2.3M |
| EVERNORTH CARE SOLUTIONS, INC. EIN 86-1465626 CONTRACT ADMINISTRATOR | Claims processing; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $66K |
| WAGEWORKS EIN 94-3351864 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $26K |
| CIGNA | Direct payment from the plan; Contract Administrator; Claims processing; Investment management Service code 12 | — | $0 |
| COMPCARE HEALTH SERVICES INS CORP EIN 39-1462554 CONTRACT ADMINISTRATOR | Other fees; Other services Service code 49 | — | $0 |
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 | 2,785 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 188 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,973 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $17K |
| Dental | DELTA DENTAL OF OHIO | 4,931 | $1.6M |
| Vision | EYEMED VISION CARE | 2,153 | $281K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,087 | $1.7M |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,087 | $1.7M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,087 | $1.7M |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 287 | $1.7M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 3,087 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,931 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.