| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICES INC. | 7200 REDWOOD BLVD, #400 NOVATO, CA 94945 | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | $10K | — | $10K | 2.12% |
| THE CORNERSTONE INSURANCE GROUP LLC3 | 721 EMERSON RD. SAINT LOUIS, MO 63141 | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | $11K | $2K | $13K | 2.92% |
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICE, INC. | 7200 REDWOOD BLVD., #400 NOVATO, CA 94945 | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | $2K | — | $2K | 0.51% |
| SSM INSURANCE SERVICES, INC.3 | ONE WILLOWBROOK COURT, SUITE 230 PETALUMA, CA 94954 | HCC LIFE INSURANCE COMPANY | — | $25K | $25K | 12.72% |
| THE CORNERSTONE INSURANCE GROUP LLC3 Filed as: CORNERSTONE INSURANCE GROUP LLC | 721 EMERSON ROAD, SUITE 500 ST. LOUIS, MO 63141 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 2.28% |
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC3 Filed as: BENEFIT ADMINISTRATIVE SYSTEMS LLC | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 1.20% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | STANDARD INSURANCE COMPANY | $11K | $4K | $15K | 10.40% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.05% |
| THE CORNERSTONE INSURANCE GROUP LLC3 | 721 EMERSON RD., STE 500 SAINT LOUIS, MO 63141 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $799 | — | $799 | 0.59% |
| SSM INSURANCE SERVICES, INC.3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 5.00% |
| CORNERSTONE BENEFITS LLC3 Filed as: THE CORNERSTONE INSURANCE | P.O. BOX 419151 ST. LOUIS, MO 63141 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 3.33% |
| ARROW BENEFITS GROUP3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 1.66% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | STANDARD INSURANCE COMPANY | $10K | $8K | $18K | 14.36% |
| SSM INSURANCE SERVICES, INC.3 | ONE WILLOWBROOK CT., #230 PETALUMA, CA 94954 | EYE MED | $2K | — | $2K | 6.65% |
| THE CORNERSTONE INSURANCE GROUP LLC3 Filed as: CORNERSTONE INSURANCE GROUP, LLC | 721 EMERSON ROAD, SUITE 500 ST. LOUIS, MO 63141 | EYE MED | $1K | — | $1K | 3.36% |
| SSM INSURANCE SERVICES, INC.3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.03% |
| CORNERSTONE BENEFITS LLC3 Filed as: THE CORNERSTONE INSURANCE | P.O. BOX 419151 ST. LOUIS, MO 63141 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.30% |
| ARROW BENEFITS GROUP3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $533 | — | $533 | 1.68% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | STANDARD INSURANCE COMPANY | $3K | $2K | $4K | 14.33% |
| SSM INSURANCE SERVICES, INC.3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $750 | — | $750 | 4.99% |
| CORNERSTONE BENEFITS LLC3 Filed as: THE CORNERSTONE INSURANCE | P.O. BOX 419151 ST. LOUIS, MO 63141 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $501 | — | $501 | 3.33% |
| ARROW BENEFITS GROUP3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $253 | $253 | 1.68% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | STANDARD INSURANCE COMPANY | $1K | $800 | $2K | 14.40% |
| SSM INSURANCE SERVICES, INC.3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $266 | — | $266 | 5.02% |
| CORNERSTONE BENEFITS LLC3 Filed as: THE CORNERSTONE INSURANCE | P.O. BOX 419151 ST. LOUIS, MO 63141 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $175 | — | $175 | 3.30% |
| ARROW BENEFITS GROUP3 | ONE WILLOWBROOK CT., SUITE 230 PETALUMA, CA 94954 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $89 | — | $89 | 1.68% |
No Schedule C service providers reported on this filing.
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 | 521 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 153 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 674 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 124 | $911K |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 299 | $278K |
| Vision | EYE MED | 494 | $35K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 674 | $252K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $28K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 521 | $62K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 360 | $193K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 674 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 674 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.