| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD | 2301 MAIN STREET KANSAS CITY, MO 64108 | BLUE CROSS BLUE SHIELD (STOP LOSS ONLY) | — | $366K | $366K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF KC EIN 43-1257251 PROVIDER NET | Other services; Direct payment from the plan; Claims processing Service code 12 | — | $226.7M |
| WILSON MCSHANE EIN 41-0956552 CONTRACT ADMIN | Accounting (including auditing); Direct payment from the plan; Contract Administrator Service code 10 | — | $492K |
| TIC INTERNATIONAL CORP EIN 13-2600875 CONTRACT ADMIN | Accounting (including auditing); Direct payment from the plan; Contract Administrator Service code 10 | — | $407K |
| ARNOLD, NEWBOLD, WINTER & JACKSON EIN 43-1174269 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $227K |
| E PLAN LLC CLAIMS NEGOTIATION | Consulting (general); Other services Service code 16 | 22601 N 19TH AVENUE #240 PHOENIX, AZ 85027 | $121K |
| LDI INTEGRATED PHARMACY SERVICES EIN 43-0912223 PRESCRIPTION SERVICES | Direct payment from the plan; Claims processing Service code 12 | — | $102K |
| COMMERCE TRUST EIN 48-0962626 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | — | $86K |
| THE UNION LABOR LIFE INSURANCE COMP EIN 13-1423090 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | — | $78K |
| PREFERRED HEALTH PROFESSIONALS EIN 43-1392960 PROVIDER NET | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $61K |
| UNITED ACTUARIAL SERVICES EIN 35-2156428 ACTUARIAL SERVICES | Direct payment from the plan; Consulting fees; Consulting (general); Actuarial Service code 11 | — | $59K |
| MARQUETTE EIN 36-3485298 INVESTMENT ADVISOR | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $50K |
| CUNEO LAWSON SHAY AND STALEY CPAS EIN 44-0642126 AUDITORS | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $40K |
| PACIFIC BANK INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | 4320 HARBORVIEW DRIVE GIG HARBOR, WA 98332 | $17K |
| LEES PRINTING EIN 48-0924320 PRINTING | Other services; Direct payment from the plan Service code 49 | — | $8K |
| HONSA BINDER PRINTING PRINTING | Direct payment from the plan; Other services Service code 49 | 320 SPRUCE STREET ST. PAUL, MN 55101 | $6K |
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 | 4,260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,608 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,868 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD (STOP LOSS ONLY) | 4,819 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,819 | — |
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.