| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALT HOLLIS | 672 PENINSULA WAY HOUSTON, AL 355723074 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 10.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | P.O. BOX 1087 WAUSAU, WI 54402 | $642K |
| GALLAGHER BENEFIT SERVICES INC. BROKER | Other commissions Service code 55 | P.O. BOX 95287 CHICAGO, IL 606945287 | $103K |
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 | 619 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 619 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 558 | $69K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 619 | $520K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 619 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 619 | — |
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.