| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOPLOSS INSURANCE SERVICES, INC. | 940 ADAMS STREET SUITE G BENICIA, CA 94510 | PAN AMERICAN LIFE INSURANCE COMPANY | $58K | — | $58K | 5.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS. OF CALIFORNIA INC | 18101 VON KARMAN AVE 6TH FL IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INS CO | $19K | — | $19K | 8.80% |
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL ST SUITE 105 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INS CO | $13K | — | $13K | 6.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Contract Administrator; Float revenue Service code 12 | — | $541K |
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $519K |
| WILLIS INSURANCE SERVICES EIN 94-1676375 BROKER | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $111K |
| BENEFITS PLANNING SERVICE EIN 33-0421912 BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $80K |
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 | 1,417 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,433 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF HAWAII | 23 | $203K |
| Vision | VISION SERVICE PLAN | 1,221 | $201K |
| Life insurance | THE LINCOLN NATIONAL LIFE INS CO | 1,994 | $53K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INS CO | 1,992 | $157K |
| Stop-loss / reinsurancereinsurance | PAN AMERICAN LIFE INSURANCE COMPANY | 1,425 | $1.1M |
| Other(4 contracts) | THE LINCOLN NATIONAL LIFE INS CO | 1,994 | $598K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,994 | — |
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."
No prospect flags tripped on this filing.