| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES3 | 315 MONTGOMERY ST STE 900 SAN FRANCISCO, CA 94104 | HCC LIFE INSURANCE COMPANY | $18K | — | $18K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHWEST ADMINISTRATORS, INC. EIN 91-0680697 NONE | Claims processing; Direct payment from the plan; Investment management fees paid directly by plan; Contract Administrator; Investment management Service code 12 | — | $565K |
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $197K |
| BARLOW COUGHRAN MORALES & JOSEPHSON EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $95K |
| PROPEL INSURANCE EIN 90-0830024 NONE | Direct payment from the plan; Insurance agents and brokers; Insurance services; Insurance brokerage commissions and fees Service code 22 | — | $49K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 NONE | Direct payment from the plan; Other services; Insurance services Service code 23 | — | $32K |
| WELLS FARGO BANK, N.A. EIN 94-1347393 NONE | Other services; Direct payment from the plan Service code 49 | — | $18K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| BMI AUDIT SERVICES, LLC EIN 38-4091484 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $9K |
| CVS PHARMACY, INC. EIN 05-0340626 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $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 | 658 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 253 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 911 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 179 | $715K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,418 | $22K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 927 | $355K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,418 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,418 | — |
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.