| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC. Filed as: STOP LOSS INSURANCE SERVICES | 940 ADAMS STREET SUITE G BENICIA, CA 94510 | HCC LIFE INSURANCE COMPANY | $42K | — | $42K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 | Participant communication; Float revenue; Named fiduciary; Contract Administrator; Non-monetary compensation; Claims processing; Other services; Direct payment from the plan Service code 12 | — | $503K |
| COMPUSYS OF UTAH, INC. EIN 85-0203669 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing Service code 12 | — | $445K |
| RAEL LETSON | Actuarial Service code 11 | 378 VINTAGE PARK DRIVE FROST CITY, CA 94404 | $132K |
| ENVISION PHARMACEUTICAL SERVICES | Claims processing Service code 12 | 2181 EAST AURORA RD 201 TWINSBURG, OH 44087 | $109K |
| MMPL | Legal Service code 29 | 2101 FOURTH AVENUE STE 2170 SEATTLE, WA 98121 | $99K |
| HAYNIE & COMPANY | Accounting (including auditing) Service code 10 | 1785 WEST 2300 SOUTH SALT LAKE CITY, UT 84119 | $39K |
| TELADOC HEALTH INC EIN 04-3705970 | Claims processing Service code 12 | 2 MANHATTANVILLE RD PURCHASE, NY 10577 | $31K |
| WASHINGTON CAPITAL MANAGEMENT, INC. | Investment management Service code 28 | 1301 FIFTH AVE STE 3100 SEATTLE, WA 981012632 | $20K |
| NEEDLES & ASSOCIATES, LLC | Accounting (including auditing) Service code 10 | 350 INTERLOCKEN BLVD S220 BROOMFIELD, CO 80021 | $16K |
| DEBOER & ASSOCIATES | Accounting (including auditing) Service code 10 | 17330 WRIGHT ST STE 100 OMAHA, NE 681302157 | $10K |
| NEPC, LLC EIN 26-1429809 | Investment advisory (plan) Service code 27 | ONE MAIN STREET CAMBRIDGE, MA 02142 | $8K |
| SERVICE PRESS INC | Copying and duplicating Service code 36 | 722 S 300 W SALT LAKE CITY, UT 84101 | $7K |
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 | 1,437 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 83 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITEDHEALTH CARE INSURANCE COMPANY | 1,413 | $85K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,507 | $831K |
| Other(2 contracts) | UNITEDHEALTH CARE INSURANCE COMPANY | 1,413 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,507 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.