| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 18940 N PIMA RD SUITE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMP OF CANADA | $20K | $22K | $41K | 9.58% |
| STEALTH PARTNER GROUP LLC3 | 9375 E SHEA BLVD STE 205 SCOTTSDALE, AZ 85260 | SUN LIFE ASSURANCE COMP OF CANADA | $8K | — | $8K | 1.76% |
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES | PO BOX 845052 LOS ANGELES, CA 90084 | SUN LIFE ASSURANCE COMP OF CANADA | $2K | — | $2K | 0.42% |
| JOSEPH MOCK3 | PO BOX 2530 ROUND ROCK, TX 78680 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $7K | — | $7K | 9.71% |
| ON TARGET INSURANCE SERVICES LLC3 | PO BOX 2530 ROUND ROCK, TX 78680 | SUN LIFE ASSURANCE COMP OF CANADA | $10K | — | $10K | 15.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $85K |
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $51K |
| ON TARGET INSURANCE SERVICES EIN 83-2963960 BROKER | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $38K |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 268 | $75K |
| Life insurance | SUN LIFE ASSURANCE COMP OF CANADA | 280 | $65K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMP OF CANADA | 170 | $432K |
| Other | SUN LIFE ASSURANCE COMP OF CANADA | 280 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.