| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | STANDARD INSURANCE COMPANY | $85K | $171K | $256K | 4.47% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | STANDARD INSURANCE COMPANY | $26K | $44K | $70K | 4.76% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | STANDARD INSURANCE COMPANY | $19K | $28K | $47K | 4.99% |
| AGIS NETWORK INC3 | 2122 KRATKY RD ST LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $65K | — | $65K | 10.00% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK, INC. | — | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 9.92% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK, INC. | — | UNUM LIFE INSURANCE COMPANY OF AMERICA | $141 | $3K | $4K | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MANAGMNT | Claims processing; Direct payment from the plan; Float revenue; Other fees Service code 12 | — | $5.0M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $715K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CLAIMS PROCESSOR | Contract Administrator; Claims processing Service code 12 | — | $115K |
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 | 1,465 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 213 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE OF CALIFORNIA | 56 | $437K |
| Vision | VISION SERVICE PLAN | 1,408 | $0 |
| Life insurance | STANDARD INSURANCE COMPANY | 1,452 | $951K |
| Short-term disability | STANDARD INSURANCE COMPANY | 1,452 | $1.5M |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,452 | $5.7M |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE OF CALIFORNIA | 56 | $421K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 1,416 | $920K |
| Other(5 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 1,475 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,475 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.