| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR5 | 220 120TH AVENUE BELLEVUE, WA 98005 | AIG BENEFIT SOLUTIONS | $5K | — | $5K | 2.50% |
| GARY LAPIDUS3 | PO BOX 547 WEIMAR, CA 95736 | LIFEMAP ASSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 220 120TH AVENUE NE BELLEVUE, WA 98005 | $84K |
| GARY LAPIDUS BROKER CONSULTANT | Insurance agents and brokers Service code 22 | PO BOX 547 WEIMAR, CA 95736 | $37K |
| ENVISION PHARMACEUTICAL SERVICES EIN 90-1011712 CONTRACT ADMINISTRATOR | Insurance services Service code 23 | 2181 E. AURORA RD SUITE 201 TWINSBURG, OH 44087 | $9K |
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 | 156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFEMAP ASSURANCE COMPANY | 156 | $59K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 156 | $59K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 156 | $59K |
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 156 | $219K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.