| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFLEX INSURANCE SERVICES LLC3 Filed as: BENEFLEX INSURANCE SERVICES INC. | 101 W ANAPAMU, THIRD FLOOR SANTA BARBARA, CA 93101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $106K | — | $106K | 20.39% |
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS COALITION SERVICES, LLC | 7632 SW DURHAM RD, SUITE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | — | $26K | 5.00% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS, LLC | 280 E 96TH ST, SUITE 250 INDIANAPOLIS, IN 46240 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | — | $13K | 2.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS OF CALIFORNIA EIN 95-4331852 NONE | Insurance agents and brokers; Other services; Claims processing; Insurance brokerage commissions and fees; Other commissions; Float revenue; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | P. O. BOX 60007 LOS ANGELES, CA 900600007 | $198K |
| EXPRESS SCRIPTS, INC. EIN 16-1279199 NONE | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | 1 EXPRESS WAY ST LOUIS, MO 63121 | $0 |
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 | 498 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $520K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $520K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.