| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALTERNATIVE RISK SOLUTIONS LLC3 Filed as: ALTERNATIVE RISK SOLUTIONS | 1390 N MCDOWELL BLVD SUITE 6283 PETALUMA, CA 94954 | RELIASTAR LIFE INSURANCE COMPANY | — | $71K | $71K | 7.00% |
| ALTERNATIVE RISK SOLUTIONS LLC3 Filed as: ALTERNATIVE RISK SOLUTIONS | 1390 N MCDOWELL BLVD SUITE 6283 PETALUMA, CA 94954 | RELIASTAR LIFE INSURANCE COMPANY | — | $51K | $51K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $2.1M |
| VAN NOY CONSULTING CONSULTING | Accounting (including auditing) Service code 10 | 2312 PROMETHEUS CT HENDERSON, NV 89074 | $220K |
| CVS HEALTH EIN 05-0340626 PHARMACY BENEFITS MANAGER | Other services; Claims processing Service code 12 | — | $212K |
| LIVONGO HEALTH INC. EIN 26-3542036 OTHER SERVICES | Other services Service code 49 | — | $176K |
| LIBERTY DENTAL PLAN OF NEVADA, INC. EIN 26-0424586 CLAIMS PROCESSING | Claims processing; Other services Service code 12 | — | $166K |
| PRUDENTRX EIN 84-4560702 CONTRACT ADMINISTRATOR | Other services; Contract Administrator Service code 13 | — | $119K |
| BEHAVIORAL HEALTHCARE OPTIONS, INC. EIN 88-0267857 SERVICE PROVIDER | Other services Service code 49 | — | $92K |
| HEALTHLINX, LLC EIN 87-0660214 OUTSIDE AUDITOR | Accounting (including auditing) Service code 10 | — | $72K |
| HARMONY HEALTHCARE EIN 04-3290453 SERVICE PROVIDER | Other services; Contract Administrator Service code 13 | — | $51K |
| VISION SERVICE PLAN EIN 23-7089668 CLAIMS PROCESSING | Claims processing Service code 12 | — | $48K |
| UNITED OF OMAHA LIFE INSURANCE CO EIN 47-0322111 CLAIMS PROCESSING | Claims processing Service code 12 | — | $44K |
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 | 7,128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 7,153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | LIBERTY DENTAL PLAN OF NEVADA, INC. | 834 | $559K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 6,722 | $1.8M |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,990 | $1.1M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 6,637 | $1.0M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 6,722 | $596K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,722 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.