| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC. Filed as: STOP LOSS INSURANCE SERVICES, INC | 940 ADAMS STREET STE. G BENICIA, CA 94510 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $57K | — | $57K | 10.00% |
| NONE | — | THE UNION LABOR LIFE INSURANCE COMPANY | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HS & BA EIN 94-3089465 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $247K |
| BLUE CROSS EIN 95-3760980 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $118K |
| SEYFARTH SHAW EIN 36-2152202 NONE | Legal; Direct payment from the plan Service code 29 | — | $39K |
| CREWS MACQUARRIE EIN 38-3647875 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $33K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $33K |
| HEMMING MORSE EIN 30-0702322 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $31K |
| BEESON, TAYER EIN 94-2148509 NONE | Legal; Direct payment from the plan Service code 29 | — | $26K |
| TEAMSTERS ASSISTANCE PROGRAM EIN 94-2825071 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $21K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $18K |
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 | 984 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 984 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 527 | $347K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,338 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.