| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES INC | PO BOX 845052 LOS ANGELES, CA 90084 | SUN LIFE ASSURANCE COMPANY OF CANADA | $46K | — | $46K | 2.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIAM C. EARHART CO., INC. EIN 93-0509592 NONE | Other fees; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication; Contract Administrator; Other services; Copying and duplicating; Claims processing Service code 12 | — | $641K |
| AETNA EIN 06-6033492 NONE | Claims processing; Insurance services; Direct payment from the plan Service code 12 | — | $315K |
| DCC, INC DBA RENALOGIC EIN 22-3857341 NONE | Direct payment from the plan; Other services Service code 49 | — | $128K |
| OGLETREE DEAKINS NASH SMOAK & STEWA EIN 57-1044820 NONE | Legal; Direct payment from the plan Service code 29 | — | $101K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Consulting (general); Actuarial Service code 11 | — | $74K |
| US BANK N.A. EIN 31-0841368 NONE | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Other services; Investment management; Custodial (securities); Direct payment from the plan Service code 19 | — | $48K |
| ADVANTRIA LLC EIN 26-0320808 NONE | Direct payment from the plan; Consulting (general); Claims processing Service code 12 | — | $40K |
| LINDQUIST LLP EIN 52-2385296 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $37K |
| HEALTHLINX EIN 87-0660214 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $28K |
| METROPRESORT EIN 93-0799990 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $15K |
| BARLOW COUGHRAN MORALES & JOSEPHSON EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $6K |
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 | 2,924 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 279 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFEMAP ASSURANCE COMPANY | 3,123 | $40K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 3,123 | $40K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,337 | $1.6M |
| Other | LIFEMAP ASSURANCE COMPANY | 3,123 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,123 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.