| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18700 N HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | BERKSHIRE HATHAWAY SPECIALTY INSURANCE CO. | $23K | — | $23K | 3.00% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18700 N HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | $8K | — | $8K | 9.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MASONRY INDUSTRY TRUST ADMIN. EIN 93-1144705 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Recordkeeping fees Service code 13 | — | $321K |
| VALENZ CLAIM | Direct payment from the plan; Consulting fees; Consulting (general) Service code 16 | PO BOX 123819 DALLAS, TX 75312 | $89K |
| MIDDLETON & CO., CPA, PC EIN 93-0809066 | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $58K |
| INNOVATIVE CARE MANAGEMENT | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | PO BOX 22386 PORTLAND, OR 97269 | $48K |
| BRADLEY L. MIDDLETON, PC EIN 93-1215960 | Legal; Direct payment from the plan Service code 29 | — | $31K |
| QUEST INVESTMENT MANAGEMENT EIN 93-0880854 | Other investment fees and expenses; Investment management; Investment management fees paid directly by plan; Direct payment from the plan Service code 28 | — | $18K |
| MARKEL AMERICAN INSURANCE EIN 54-1398877 | Direct payment from the plan; Other insurance fees and expenses; Insurance services Service code 23 | — | $7K |
| MILLIMAN EIN 91-0675641 | Consulting fees; Direct payment from the plan; Actuarial Service code 11 | 1455 SW BROADWAY STE 1600 PORTLAND, OR 97201 | $5K |
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 | 476 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 65 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 541 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 7 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 204 | $1.1M |
| Dental(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,084 | $1.5M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 204 | $1.1M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 492 | $22K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 983 | $1.6M |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE CO. | 426 | $772K |
| Other(8 contracts, 7 carriers) | HCC LIFE INSURANCE COMPANY | 492 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,084 | — |
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.