| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST. 6TH FL SAN DIEGO, CA 92101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $57K | — | $57K | 17.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE ST. STE 200 NEWPORT BEACH, CA 92660 | SUN LIFE ASSURANCE COMPANY OF CANADA | $30K | — | $30K | 9.00% |
| UMR, INC.3 | 11 SCOTT ST. STE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 0.67% |
| ALLIANT INSURANCE SERVICES, INC.3 | 6550 ROCK SPRING DRIVE STE. 610 BETHESDA, MD 20817 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.56% |
| ALLIANT INSURANCE SERVICES, INC.3 | 6550 ROCK SPRING DRIVE STE. 610 BETHESDA, MD 20817 | DOMINION DENTAL SERVICES, INC. | $3K | — | $3K | 7.44% |
| ALLIANT INSURANCE SERVICES, INC.3 | 6550 ROCK SPRING DR. STE 610 BETHESDA, MD 20817 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.24% |
| ALLIANT INSURANCE SERVICES, INC.3 | 6550 ROCK SPRING DR. STE 610 BETHESDA, MD 20817 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.19% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FL SAN DIEGO, CA 92101 | UNITED HEALTHCARE INSURANCE COMPANY | $763 | — | $763 | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PBM | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $328K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $201K |
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 | 108 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 206 | $11K |
| Dental(2 contracts, 2 carriers) | DOMINION DENTAL SERVICES, INC. | 206 | $52K |
| Vision(2 contracts, 2 carriers) | DOMINION DENTAL SERVICES, INC. | 206 | $52K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $52K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 47 | $13K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 34 | $18K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 109 | $333K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 206 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.