| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY INSURANCE SERVICES3 Filed as: LIBERTY INSURANCE AGENCY | 1910 COCHRAN ROAD SUITE 800 PITTSBURGH, PA 15220 | NATIONAL UNION FIRE INSURANCE COMPANY OF PA | $3K | — | $3K | 5.00% |
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES | 940 ADAMS STREET SUITE G BENEICIA, CA 94510 | NATIONAL UNION FIRE INSURANCE COMPANY OF PA | $3K | — | $3K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PINNACLE CLAIMS MANAGEMENT, INC TPA | Contract Administrator; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 15525 SAND CANYON AVE IRVINE, CA 92618 | $1.1M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CARRIER | Participant communication; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 515 SOUTH FLOWER SUITE 505 LOS ANGELES, CA 90071 | $13K |
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 | 494 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 494 | $288K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 494 | $288K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 494 | $288K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 494 | $288K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 494 | $348K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.