| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | $5K | $2K | $7K | 14.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH TPA | Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | 980 JOLLY ROAD BLUEBELL, PA 19422 | $272K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 515 SOUTH FLOWER SUITE 505 LOS ANGELES, CA 90071 | $20K |
| VISION SERVICE PLAN EIN 94-1632821 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $12K |
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 | 574 | 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) | 574 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 263 | $1.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 277 | $50K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 769 | $309K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 769 | $309K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 769 | $309K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 263 | $1.6M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 769 | $358K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 769 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.