| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP, LLC | 18700 N. HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | — | $54K | $54K | 5.95% |
| AVANT SPECIALTY BENEFITS LLC3 Filed as: AVANT SPECIALTY BENEFITS, LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 2.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $155 | $155 | 0.02% |
| AVANT SPECIALTY BENEFITS LLC3 Filed as: AVANT SPECIALTY BENEFITS, LLC | 1828 WALNUT STREET SUITE 701 KANSAS CITY, MO 641082150 | RELIASTAR LIFE INSURANCE COMPANY | $24K | — | $24K | 20.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES | P.O. BOX 441 ATTN OPERATING ACCOUNT DES MOINES, IA 50302 | RELIASTAR LIFE INSURANCE COMPANY | $3K | — | $3K | 2.26% |
| T2B SOLUTIONS INC.3 Filed as: T2B SOLUTIONS, INC. | P.O. BOX 43 INDIANOLA, IA 50125 | RELIASTAR LIFE INSURANCE COMPANY | — | $285 | $285 | 0.24% |
| DIANE REEVES4 Filed as: DIANE LEE REEVES | 7000 N 16TH STREET PHOENIX, AZ 85020 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $5K | — | $5K | 17.08% |
| VICKY METHVEN4 | 370 GREEN OAK DRIVE KERRVILLE, TX 78028 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $66 | — | $66 | 0.24% |
| GILLIAN O. MOON4 | 1385 BOSTWICK ROAD KETCHIKAN, AK 99901 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $50 | — | $50 | 0.18% |
| UNIQUE BENEFITS GROUP INC4 Filed as: UNIQUE BENEFITS GROUP, INC. | 7 CAPOZZI CIR WOBURN, MA 01801 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $38 | — | $38 | 0.14% |
| GOODKIND MARKETING GROUP, INC.4 | 2549 EASTBLUFF DRIVE UNIT B-333 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $26 | — | $26 | 0.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $312K |
| PRUDENTIAL INS. CO. OF AMERICA EIN 22-1211670 SERVICE PROVIDER | Other services Service code 49 | — | $43K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $36K |
| ACI EIN 33-0619312 SERVICE PROVIDER | Other services Service code 49 | — | $21K |
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 | 789 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 802 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 172 | $1.3M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,221 | $88K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 808 | $648K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 808 | $648K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 625 | $905K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 808 | $794K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,221 | — |
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.