| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 1705 17TH STREET, SUITE 100 DENVER, CO 80202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $201K | $201K | 4.78% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $54K | $54K | 1.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Direct payment from the plan; Other services Service code 12 | — | $3.6M |
| CAPITAL RX EIN 35-2612946 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $716K |
| TRIA HEALTH EIN 27-1515235 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $258K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $251K |
| COMPSYCH EIN 36-3739783 NONE | Direct payment from the plan; Other services; Other fees; Claims processing; Plan Administrator Service code 12 | — | $132K |
| VISION SERVICE PLAN EIN 36-3560825 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $117K |
| EMPLOYER DIRECT HEALTHCARE, LLC NONE | Direct payment from the plan; Other services Service code 49 | 2100 ROSS AVENUE SUITE 550 DALLAS, TX 75201 | $68K |
| WEX EIN 06-1593514 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $22K |
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 | 5,204 | 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) | 5,204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 243 | $1.8M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 8 | $50K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,204 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,204 | — |
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.