| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINANCIAL AND I | 28470 AVENUE STANFORD STE 300 VALENCIA, CA 91355 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $155K | $55K | $210K | 13.55% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINANCIAL AND I | 28470 AVENUE STANFORD STE 300 VALENCIA, CA 91355 | BLUE CROSS AND BLUE SHIELD OF ALABAMA | $0 | — | $0 | 0.00% |
| UTIC INSURANCE COMPANY3 | 450 RIVERCHASE PARKWAY EAST BIRMINGHAM, AL 352442858 | BCS INSURANCE COMPANY | — | $60K | $60K | 10.00% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINANCIAL AND I | 28470 AVENUE STANFORD STE 300 VALENCIA, CA 91355 | VISION SERVICE PLAN | $5K | — | $5K | 1.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS CAREMARK EIN 05-0340626 CLAIMS/FEES/ADMIN RX | Contract Administrator; Claims processing Service code 12 | — | $5.7M |
| BCBS OF AL (75769) EIN 63-0103830 CLAIM ADMIN MED | Claims processing; Direct payment from the plan; Participant communication; Contract Administrator Service code 12 | — | $749K |
| AMERICAN BEHAVIORAL BENEFITS MANAGE EIN 63-1030881 CLAIM ADMIN EAP | Participant communication; Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $408K |
| COMPSYCH EIN 35-3739783 CLAIM ADMIN EAP | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | — | $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 | 1,429 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,446 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 1,290 | $743K |
| Vision | VISION SERVICE PLAN | 1,149 | $242K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,429 | $1.5M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,429 | $1.5M |
| Stop-loss / reinsurancereinsurance | BCS INSURANCE COMPANY | 1,364 | $602K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,429 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,429 | — |
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.