| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | — | $992 | $992 | 0.12% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18940 N PIMA ROAD SUITE 210 SCOTTSDALE, AZ 85255 | SUNLIFE ASSURANCE COMPANY OF CANADA | $24K | $18K | $42K | 8.67% |
| UMR, INC.3 | 11 SCOTT STREET SUITE 100 WAUSAU, WA 54403 | SUNLIFE ASSURANCE COMPANY OF CANADA | — | $3K | $3K | 0.66% |
| AVANT SPECIALTY BENEFITS LLC3 Filed as: AVANT SPECIALTY BENEFITS, LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $21K | — | $21K | 5.13% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $91 | $91 | 0.02% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $15 | $15 | 0.00% |
| HOLMES MURPHY & ASSOCIATES3 | P.O. BOX 441 DES MOINES, IA 50302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | — | $21K | 9.55% |
| AVANT SPECIALTY BENEFITS LLC3 Filed as: AVANT SPECIALTY BENEFITS, LLC | 1828 WALNUT STREET SUITE 701 KANSAS CITY, MO 641082150 | RELIASTAR LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, LLC | P.O. BOX 441 DES MOINES, IA 50302 | RELIASTAR LIFE INSURANCE COMPANY | $719 | — | $719 | 2.85% |
| DIANE REEVES4 | 12160 SAN TOMAS PLACE SAN DIEGO, CA 92128 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $3K | — | $3K | 24.30% |
| GOODKIND MARKETING GROUP, INC.4 | 2549 EASTBLUFF DRIVE UNIT B-333 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $22 | — | $22 | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $258K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $18K |
| ACI SPECIALTY BENEFITS EIN 33-0619312 SERVICE PROVIDER | Other services Service code 49 | — | $13K |
| PRUDENTIAL INSURANCE CO OF AMER. EIN 22-1211670 SERVICE PROVIDER | Other services Service code 49 | — | $12K |
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 | 505 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 513 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 133 | $814K |
| Dental | ALPHA DENTAL OF ARIZONA, INC. | 233 | $29K |
| Vision | EYEMED | 784 | $55K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 505 | $414K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 505 | $414K |
| Stop-loss / reinsurancereinsurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 393 | $483K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 505 | $676K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 784 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.