| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | AMWINS(RELIASTAR LIFE INSURANCE CO) | $75K | $0 | $75K | 5.00% |
| STEALTH PARTNER GROUP LLC3 | 18940 N PIMA RD STE 210 SCOTTSDALE, AZ 85255 | AMWINS(RELIASTAR LIFE INSURANCE CO) | $37K | $0 | $37K | 2.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE SHIELD OF CALIFORNIA EIN 94-0360524 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $160K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $120K |
| RAEL AND LETSON EIN 94-1701048 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $106K |
| EMPLOYEE #1 EIN 94-1268305 EMPLOYEE OF AFFIL. TRUST | Employee (plan) Service code 30 | — | $84K |
| UNITED CONCORDIA EIN 25-1687586 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $82K |
| MESVISION EIN 95-4354242 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $67K |
| KRAW LAW GROUP, APC EIN 32-0465891 NONE | Legal; Direct payment from the plan Service code 29 | — | $61K |
| EMPLOYEE #4 EIN 94-1268305 EMPLOYEE OF AFFIL. TRUST | Employee (plan) Service code 30 | — | $61K |
| EMPLOYEE #5 EIN 94-1268305 EMPLOYEE OF AFFIL. TRUST | Employee (plan) Service code 30 | — | $60K |
| EMPLOYEE #3 EIN 94-1268305 EMPLOYEE OF AFFIL. TRUST | Employee (plan) Service code 30 | — | $59K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $57K |
| CALIBER NETWORKS EIN 27-2155341 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $50K |
| EMPLOYEE #2 EIN 94-1268305 EMPLOYEE OF AFFIL. TRUST | Employee (plan) Service code 30 | — | $44K |
| ISLIP & CO. EIN 68-0344156 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $26K |
| WITHUMSMITH + BROWN, PC EIN 22-2072092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $21K |
| VICTOR X BERTOLANI NONE | Legal; Direct payment from the plan Service code 29 | 8801 FOLSOM BLVD STE 192 SACRAMENTO, CA 95826 | $7K |
| MERRILL LYNCH PIERCE FENNER & SMITH EIN 13-5674085 NONE | Sub-transfer agency fees; Custodial (other than securities); Distribution (12b-1) fees Service code 18 | — | $0 |
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 | 980 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 232 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS, INC | 1,658 | $14.9M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 160 | $78K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMP | 1,046 | $86K |
| Stop-loss / reinsurancereinsurance | AMWINS(RELIASTAR LIFE INSURANCE CO) | 567 | $1.5M |
| Other | THE UNION LABOR LIFE INSURANCE COMP | 1,046 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,658 | — |
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.