| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS DBA BENEFITMALL | 4851 LBJ FRWY SUITE 100 DALLAS, TX 75244 | SYMETRA LIFE INSURANCE COMPANY | $0 | $21K | $21K | 5.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $0 | $7K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $0 | $8K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $0 | $7K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $0 | $6K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S. 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | EYEMED VISION CARE | $106 | $0 | $106 | 0.28% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 3295 N FORT APACHE RD SUITE 150 LAS VEGAS, NV 891290209 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.83% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.26% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | METLIFE LEGAL PLANS | $1K | $0 | $1K | 9.13% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 3295 N FORT APACHE ROAD SUITE 150 LAS VEGAS, NV 89129 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 3295 N FORT APACHE RD STE 150 LAS VEGAS, NV 89129 | METROPOLITAN GENERAL INSURANCE COMPANY | $99 | $0 | $99 | 10.00% |
No Schedule C service providers reported on this filing.
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 | 637 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 643 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 110 | $611K |
| Dental | HAWAII DENTAL SERVICE | 70 | $30K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 599 | $595K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 587 | $124K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 121 | $62K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 96 | $43K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 74 | $557K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 375 | $423K |
| Other(7 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 587 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 599 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.