| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES | 940 ADAMS ST SUITE G BENICIA, CA 94510 | PAN AMERICAN LIFE INSURANCE CO | $22K | — | $22K | 5.00% |
| JOSEPH MOCK3 Filed as: JOSEPH D. MOCK | PO BOX 2530 ROUND ROCK, TX 786802530 | THE LINCOLN NATIONAL LIFE INS CO | $5K | — | $5K | 10.00% |
| JOSEPH MOCK3 Filed as: JOSEPH D. MOCK | PO BOX 2530 ROUND ROCK, TX 786802530 | THE LINCOLN NATIONAL LIFE INS CO | $3K | — | $3K | 10.00% |
| JOSEPH MOCK3 Filed as: JOSEPH D. MOCK | PO BOX 2530 ROUND ROCK, TX 786802530 | THE LINCOLN NATIONAL LIFE INS CO | $4K | — | $4K | 15.00% |
| JOSEPH MOCK3 Filed as: JOSEPH D. MOCK | PO BOX 2530 ROUND ROCK, TX 786802530 | THE LINCOLN NATIONAL LIFE INS CO | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $87K |
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Other fees; Direct payment from the plan Service code 50 | — | $47K |
| ALL AMERICAN RESOURCE GR EIN 46-3237776 BROKER | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $45K |
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 | 255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | THE LINCOLN NATIONAL LIFE INS CO | 109 | $76K |
| Life insurance | THE LINCOLN NATIONAL LIFE INS CO | 255 | $13K |
| Stop-loss / reinsurancereinsurance | PAN AMERICAN LIFE INSURANCE CO | 197 | $439K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INS CO | 255 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.