| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS COALITION SERVICES, LLC | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $42K | — | $42K | 3.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS,LLC EIN 36-4197088 CLAIMS PROCESSOR | Claims processing Service code 12 | 17475 JOVANNA DR, STE 18 HOMEWOOD, IL 60430 | $19.1M |
| UNITED HEALTHCARE SERVICES EIN 41-1289245 CLAIMS PROCESSOR | Claims processing Service code 12 | 9900 BREN ROAD EAST MINNETONKA, MN 55343 | $3.3M |
| THE BENEFIT COMPANY EIN 06-1740690 INSURANCE AGENT / BROKER | Insurance agents and brokers Service code 22 | 6 CONCOURSE PKWY,STE 2750 ATLANTA, GA 30328 | $255K |
| OGLETREE DEAKINS NASH SMOAK STEWART EIN 57-1044820 LEGAL | Legal Service code 29 | 191 PEACHTREE ST,STE 4800 ATLANTA, GA 30308 | $70K |
| HODGES MACE (CONTINOUS HEALTH) EIN 27-5782040 INSURANCE SERVICES | Insurance services Service code 23 | 5775-D GLENRIDGE DRIVE ATLANTA, GA 30328 | $14K |
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 | 3,953 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 278 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,092 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,092 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.