| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES, INC. | 141 W GREEN STREET PASADENA, CA 91105 | LINCOLN LIFE ASSURANCE CO OF BOSTON | $59K | $0 | $59K | 6.00% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES, INC. | 141 W GREEN STREET PASADENA, CA 91105 | LINCOLN LIFE ASSURANCE CO OF BOSTON | $37K | $0 | $37K | 6.00% |
| STEALTH PARTNER GROUP LLC3 | 18940 N PIMA RD SUITE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE CO OF CANADA | $28K | $24K | $51K | 8.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 22-3461740 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $4.0M |
| UNITED HEALTHCARE SERVICES INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $1.2M |
| ALLEGIANT CARE EIN 02-6015031 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $828K |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $73K |
| LINCOLN LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $299 |
| WILLIS COROON CORP OF IL INC EIN 36-2691200 BROKER | Other commissions Service code 55 | 233 S WACKER DRIVE CHICAGO, IL 60606 | -$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 | 2,253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 88 | $609K |
| Vision | VISION SERVICE PLAN | 1,451 | $232K |
| Short-term disability | LINCOLN LIFE ASSURANCE CO OF BOSTON | 2,253 | $982K |
| Long-term disability | LINCOLN LIFE ASSURANCE CO OF BOSTON | 2,010 | $625K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 88 | $619K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE CO OF CANADA | 1,651 | $605K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,253 | — |
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.