| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMAGE FINANCIAL & INSURANCE SERV3 Filed as: IMAGE FINANCIAL | 550 CALIFORNIA ST SUITE 130 SAN FRANCISCO, CA 94104 | UNIMERICA LIFE INSURANCE COMPANY | $33K | — | $33K | 10.00% |
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES | 940 ADAMS STREET SUITE G BENICIA, CA 94510 | UNIMERICA LIFE INSURANCE COMPANY | $17K | — | $17K | 5.00% |
| IMAGE FINANCIAL & INSURANCE SVCS3 | 225 BUSH ST SUITE 1820 SAN FRANCISCO, CA 94104 | PRUDENTIAL INSURANCE CO OF AMERICA | $17K | — | $17K | 19.10% |
| IMAGE FINANCIAL & INS SERVS OF N CA3 | 565 COMMERCIAL ST 4TH FLOOR SAN FRANCISCO, CA 94111 | UNITED OF OMAHA LIFE INS CO | $4K | — | $4K | 9.32% |
| IMAGE FINANCIAL & INS SERVS OF N CA3 | 565 COMMERCIAL ST 4TH FLOOR SAN FRANCISCO, CA 94111 | UNITED OF OMAHA LIFE INS CO | $7K | — | $7K | 15.00% |
| IMAGE FINANCIAL & INSURANCE SERV3 | 565 COMMERICIAL ST 4TH FLOOR SAN FRANCISCO, CA 94111 | CLAREMONT EAP | $518 | — | $518 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $114K |
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Other fees; Direct payment from the plan Service code 50 | — | $93K |
| IMAGE FINANCIAL & INS. SERV. EIN 94-3101411 BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $54K |
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 | 234 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE CO OF AMERICA | 248 | $112K |
| Short-term disability | UNITED OF OMAHA LIFE INS CO | 248 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INS CO | 248 | $46K |
| Stop-loss / reinsurancereinsurance | UNIMERICA LIFE INSURANCE COMPANY | 236 | $330K |
| Other | CLAREMONT EAP | 238 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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.