| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036155 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $655 | $655 | 0.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS, INC EIN 52-1590516 NONE | Contract Administrator Service code 13 | — | $1.1M |
| AETNA EIN 06-6033492 NONE | Consulting (general); Claims processing Service code 12 | — | $441K |
| INNOVATIVE CARE MANAGEMENT, INC EIN 93-1087669 NONE | Consulting (general) Service code 16 | — | $189K |
| SEGAL COMPANY (WESTERN STATES), INC EIN 94-1503999 NONE | Consulting (general) Service code 16 | — | $136K |
| ENVISION PHARMACEUTICAL SERVICES EIN 05-0570786 NONE | Claims processing Service code 12 | — | $129K |
| CHRISTENSEN, JAMES & MARTIN EIN 88-0330440 NONE | Legal Service code 29 | — | $83K |
| CECILIA B. BACERO EMPLOYEE | Employee (plan) Service code 30 | 2250 S. RANCHO DRIVE, SUITE 295 LAS VEGAS, NV 89102 | $82K |
| HARMONY HEALTHCARE EIN 04-3290453 NONE | Consulting (general); Claims processing Service code 12 | — | $71K |
| PDQ PRINTING EIN 20-3649287 NONE | Copying and duplicating Service code 36 | — | $67K |
| HEALTH SERVICES COALITION EIN 88-0492643 NONE | Consulting (general) Service code 16 | — | $62K |
| CAREOPERATIVE, LLC EIN 46-4399706 NONE | Other services Service code 49 | — | $61K |
| A&B PRINTING & MAILING EIN 88-0474575 NONE | Copying and duplicating Service code 36 | — | $53K |
| STEWART, ARCHIBALD & BARNEY, LLP EIN 88-0382649 NONE | Accounting (including auditing) Service code 10 | — | $36K |
| WELLS FARGO BANK EIN 41-1492157 NONE | Custodial (securities) Service code 19 | — | $32K |
| DIVERSIFIED DENTAL SERVICES, INC EIN 88-0346054 NONE | Claims processing; Consulting (general) Service code 12 | — | $23K |
| WELLS CAPITAL MANAGEMENT EIN 95-3692822 NONE | Investment management Service code 28 | — | $15K |
| HEALTH STRATEGIES, INC EIN 86-0851201 NONE | Consulting (general) Service code 16 | — | $11K |
| MAXIM HEALTH SYSTEMS, LLC EIN 52-1968516 NONE | Consulting (general) Service code 16 | — | $6K |
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 | 3,151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 139 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH PLAN OF NEVADA / SIERRA HEALTH & LIFE | 1,975 | $4.3M |
| Dental | LIBERTY DENTAL PLAN OF NEVADA, INC. | 667 | $131K |
| Vision(2 contracts, 2 carriers) | HEALTH PLAN OF NEVADA / SIERRA HEALTH & LIFE | 3,332 | $4.7M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,285 | $127K |
| Prescription drug | HEALTH PLAN OF NEVADA / SIERRA HEALTH & LIFE | 1,975 | $4.3M |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,731 | $194K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,285 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,332 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.