| 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 | THE NORTH RIVER INSURANCE CO | — | $63K | $63K | 7.00% |
| ALTERNATIVE RISK SOLUTIONS LLC3 Filed as: ALTERNATIVE RISK SOLUTIONS | 1390 N MCDOWELL BLVD SUITE 6283 PETALUMA, CA 94954 | THE NORTH RIVER INSURANCE CO | — | $45K | $45K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $3.4M |
| CVS HEALTH EIN 05-0340626 PHARMACY BENEFITS MANAGER | Other services; Claims processing Service code 12 | — | $1.8M |
| VAN NOY CONSULTING CONSULTING | Accounting (including auditing) Service code 10 | 2312 PROMETHEUS CT HENDERSON, NV 89074 | $240K |
| LIBERTY DENTAL PLAN OF NEVADA EIN 26-0424586 CLAIMS PROCESSING | Claims processing; Other services Service code 12 | — | $206K |
| PHC OF NEVADA INC. D/B/A HARMONY HC EIN 04-3290453 CONTRACT PROVIDER & OTHER | Other services; Contract Administrator Service code 13 | — | $198K |
| LIVONGO HEATLH, INC EIN 26-3542036 OTHER SERVICES | Other services Service code 49 | — | $112K |
| UNITED OF OMAHA LIFE INSURANCE COMP EIN 47-0322111 CLAIMS PROCESSING | Claims processing Service code 12 | — | $51K |
| PRUDENT RX, LLC EIN 84-4560702 CONTRACT ADMINISTRATION | Contract Administrator; Other services Service code 13 | — | $50K |
| VISION SERVICE PLAN EIN 23-7089668 CLAIMS PROCESSING | Claims processing Service code 12 | — | $46K |
| WIPFLI, LLP EIN 39-0758449 OUTSIDE AUDITOR | Accounting (including auditing) Service code 10 | — | $10K |
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 | 6,721 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 6,721 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | LIBERTY DENTAL PLAN OF NEVADA, INC. | 821 | $648K |
| Life insurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 6,719 | $2.1M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 904 | $183K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,902 | $1.3M |
| Stop-loss / reinsurancereinsurance | THE NORTH RIVER INSURANCE CO | 6,292 | $898K |
| Other(3 contracts, 2 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 6,719 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,719 | — |
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.