| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMDY INSURANCE SERVICES3 | 315 MONTGOMERY ST STE 900 SAN FRANCISCO, CA 94104 | HCC LIFE INSURANCE COMPANY | $21K | — | $21K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHWEST ADMINISTRATORS, INC. EIN 91-0680697 NONE | Investment management; Contract Administrator; Investment management fees paid directly by plan; Claims processing; Direct payment from the plan Service code 12 | — | $435K |
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $223K |
| PROPEL INSURANCE EIN 90-0830024 NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees; Consulting (general) Service code 16 | — | $52K |
| BARLOW COUGHRAN MORALES & JOSEPHSON EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $41K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 NONE | Other services; Insurance services; Direct payment from the plan Service code 23 | — | $40K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $18K |
| WELLS FARGO BANK, N.A. EIN 94-1347393 NONE | Other services; Direct payment from the plan Service code 49 | — | $18K |
| HEALTHCARE ACTUARIES LLC EIN 20-5718833 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $9K |
| SERVICE PRINTING CO. INC. EIN 91-0830372 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $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 | 755 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 121 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 876 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY OF NEW YORK | 151 | $547K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 733 | $31K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 733 | $31K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 947 | $420K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 947 | — |
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.