| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHCARE PROVIDER RESOURCES, INC.3 Filed as: HEALTHCARE PROVIDER RESOURCES | 258 SCENIC VIEW TERRACE PEGRAM, TN 37143 | PARTNERRE AMERICAN INSURANCE COMPANY | $63K | — | $63K | 10.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN ST 21ST FL SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $3K | $24K | 11.77% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN ST 21ST FL SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $1K | $11K | 12.54% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN ST 21ST FL SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $10K | 11.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ADVANTEK BENEFIT ADMINISTRATORS EIN 77-0382381 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | P.O. BOX 45007 FRESNO, CA 93718 | $203K |
| BLUE CROSS LIFE & HEALTH INSURANCE | Other services Service code 49 | DEPARTMENT 5812 LOS ANGELES, CA 90074 | $152K |
| RX - US CARE | Other services Service code 49 | P.O. BOX 4328 TORRANCE, CA 90510 | $27K |
| KEENAN & ASSOCIATES EIN 95-2798626 | Other services Service code 49 | P.O. BOX 4328 TORRANCE, CA 90510 | $22K |
| MULTIPLAN, INC. EIN 13-3068979 | Other services Service code 49 | 115 FIFTH AVENUE NEW YORK, NY 10003 | $18K |
| VISION SERVICE PLAN EIN 94-1632821 CLAIMS ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $17K |
| THE DENTAL PPA EIN 26-0603616 | Other services Service code 49 | PMB 261 4719 QUAIL LAKES DR, STE G STOCKTON, CA 95207 | $14K |
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 | 933 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 933 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,062 | $171K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,062 | $88K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,062 | $292K |
| Stop-loss / reinsurancereinsurance | PARTNERRE AMERICAN INSURANCE COMPANY | 718 | $632K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,062 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,062 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.