| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY CO INS BROKERS INC | — | STANDARD INSURANCE COMPANY | $12K | — | $12K | 12.79% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY CO INS BROKERS INC | — | STANDARD INSURANCE COMPANY | $3K | — | $3K | 15.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP LLC EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $108K |
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services Service code 12 | — | $70K |
| MCINNES MAGGART CONSULTING EIN 48-1108277 BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $31K |
| MEDTRAK SERVICES, LLC EIN 36-4221427 RX VENDOR | Direct payment from the plan; Claims processing Service code 12 | — | $22K |
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 | 244 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 275 | $14K |
| Vision | VISION SERVICE PLAN | 279 | $38K |
| Life insurance | STANDARD INSURANCE COMPANY | 289 | $92K |
| Long-term disability | STANDARD INSURANCE COMPANY | 41 | $18K |
| Stop-loss / reinsurancereinsurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 246 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.