| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MTN STATES LTD | — | DELTA DENTAL | $3K | — | $3K | 0.09% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVE. DALLAS, TX 75201 | AETNA LIFE INSURANCE CO. | $158K | — | $158K | 4.87% |
| LOCKTON COMPANIES, LLC3 | DEPT 3042 DALLAS, TX 75312 | AETNA LIFE INSURANCE CO. | $158K | — | $158K | 4.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX EIN 33-0441200 PHARMACY BENEFIT MGMT. | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | — | $3.3M |
| HEALTH BRIDGES OF NORTHER CA EIN 47-1308284 CONTRACT ADMIN | Claims processing; Plan Administrator Service code 12 | — | $2.7M |
| WEBTPA EIN 75-2611444 CONTRACT ADMIN | Custodial (securities); Claims processing; Consulting (general); Insurance services; Actuarial; Contract Administrator Service code 11 | — | $647K |
| ASCENDANT HEALTH CARE EIN 26-3768186 CONTRACT ADMIN | Insurance services; Contract Administrator Service code 13 | — | $459K |
| AETNA NETWORK SERVICES EIN 06-6033492 CONTRACT ADMIN | Contract Administrator; Insurance services Service code 13 | — | $226K |
| HEALTHCARE STRATEGIES CCMU EIN 52-1874471 CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $153K |
| BEST DOCTORS EIN 04-2908444 CONTRACT ADMIN | Contract Administrator; Other services; Direct payment from the plan Service code 13 | — | $118K |
| PAYFLEX COBRA EIN 91-1774434 CONTRACT ADMIN | Claims processing Service code 12 | — | $20K |
| PROGYNY EIN 75-2477745 CONTRACT ADMIN | Insurance services; Other services; Claims processing Service code 12 | — | $19K |
| COLOR GENOMICS EIN 46-3353585 CONTRACT ADMIN | Other services Service code 49 | — | $10K |
| CEUTICARE COMPANY EIN 46-4845874 CONTRACT ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $550 |
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 | 4,347 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 83 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,430 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 5,205 | $29.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL | 4,451 | $4.0M |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 5,205 | $29.4M |
| Life insurance | FOUR EVER LIFE INS. CO. | 17 | $79K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 5,205 | $29.0M |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 2,127 | $3.3M |
| Other | CURALINC, LLC, D.B.A. CURALINC HEALTHCARE | 4,816 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,205 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.