| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 3470 MT DIABLO BLVD STE A100 LAFAYETTE, CA 945493958 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | — | $9K | 3.76% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES INC (IL) | 5 REVERE DRIVE, STE. 130 NORTHBROOK, IL 60062 | EYEMED VISION CARE | $8K | — | $8K | 6.97% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (IL) INC | 5 REVERE DRIVE, STE. 130 NORTHBROOK, IL 60062 | HMO ILLINOIS | $3K | — | $3K | 4.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $745K |
| NFP CORPORATE SERVICES IL INC | Other commissions Service code 55 | — | $76K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIMS ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Float revenue; Non-monetary compensation; Claims processing; Participant communication; Other services Service code 12 | — | $49K |
| BENEFLEX HR RESOURCES, INC. EIN 26-4445781 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 10805 SUNSET OFFICE DRIVE SUITE 401 ST LOUIS, MO 63127 | $12K |
| NFP CORPORATE SERVICES IL INC. | Other commissions Service code 55 | — | $5K |
| NFP CORPORATE SERVICES (IL) INC. EIN 13-4090309 BROKER | Other commissions Service code 55 | 5 REVERE DR. STE 130 NORTHBROOK, IL 60062 | $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 | 979 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 986 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 48 | $491K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 151 | $60K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE | 1,616 | $181K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 889 | $311K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 151 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,616 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.