| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES, INC | — | WESTPORT INSURANCE CORPORATION | $10K | — | $10K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Direct payment from the plan; Contract Administrator; Copying and duplicating Service code 13 | — | $403K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $140K |
| ANTHEM, INC. EIN 95-3760980 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $90K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $50K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $48K |
| BEESON, TAYER & BODINE, APC EIN 94-3126136 NONE | Legal; Direct payment from the plan Service code 29 | — | $45K |
| ZELIS CLAIMS INTEGRITY, LLC EIN 86-1040704 NONE | Direct payment from the plan; Other services Service code 49 | — | $40K |
| MANAGED HEALTH NETWORK EIN 95-4146179 NONE | Claims processing; Direct payment from the plan; Other services Service code 12 | — | $34K |
| ALAN BILLER AND ASSOCIATES EIN 94-2854958 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $25K |
| TEAMSTERS ASSISTANCE PROGRAM EIN 68-0048516 NONE | Other services; Direct payment from the plan Service code 49 | — | $21K |
| IRON MOUNTAIN EIN 04-3038590 NONE | Other services; Direct payment from the plan Service code 49 | — | $16K |
| CITY NATIONAL BANK EIN 95-1780067 NONE | Direct payment from the plan; Custodial (other than securities); Other services Service code 18 | — | $16K |
| OPTUM RX, INC EIN 33-0441200 NONE | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | — | $9K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $5K |
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 | 874 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 418 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,614 | $11.4M |
| Dental | NEWPORT DENTAL PLAN | 96 | $66K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,127 | $136K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 424 | $207K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 1,127 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,614 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.