| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18700 N HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $212K | $54K | $266K | 5.75% |
| AON CONSULTING INC3 Filed as: AON SOLUTIONS CANADA, INC | — | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $14K | $0 | $14K | 14.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMIN | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $112K |
| LIFTAFFECT INC EIN 93-4168487 CARRIER | Insurance services Service code 23 | 10794 CEDAR BROOK ST. HIGHLANDS RANCH, CO 80126 | $97K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CARRIER | Contract Administrator; Claims processing Service code 12 | — | $16K |
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 | 3,928 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,928 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 71 | $198K |
| Vision(3 contracts, 3 carriers) | VISION SERVICE PLAN | 3,577 | $1.1M |
| Life insurance | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 71 | $93K |
| Long-term disability | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 71 | $93K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,331 | $4.6M |
| Other(3 contracts, 2 carriers) | METLIFE LEGAL PLANS OF FLORIDA | 1,181 | $393K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,577 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.