| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNER | 1540 CORNERSTONE BLVD SUITE 230 DAYTONA BEACH, FL 32117 | WELLPOINT STOP LOSS | $11K | $38K | $49K | — |
| RENBERG COMPLIANCE3 Filed as: RENBERG COMPLIANCE & INS SVCS | 7395 N PALM BLUFFS AVE SUITE 105 FRESNO, CA 93711 | SUN LIFE ASSURANCE COMPANY OF CANADA | $27K | — | $27K | — |
| RENBERG COMPLIANCE3 Filed as: RENBERG COMPLIANCE & INS SVCS | 7395 N PALM BLUFFS AVE SUITE 105 FRESNO, CA 93711 | SUN LIFE ASSURANCE COMPANY OF CANADA | $27K | — | $27K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Other services; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $0 |
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $0 |
| RENBERG COMPLIANCE & INSURANCE SERV EIN 77-0565110 BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $0 |
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 | 420 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PREMIER ACCESS INSURANCE COMPANY | 0 | $0 |
| Life insurance(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 548 | $0 |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 548 | $0 |
| Long-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 548 | $0 |
| Stop-loss / reinsurancereinsurance | WELLPOINT STOP LOSS | 4,071 | $0 |
| Other(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 548 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,071 | — |
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.