| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN | — | — | $0 | 0.00% |
| NONE | — | UNITEDHEALTHCARE INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | TOKIO MARINE HCC STOP LOSS GROUP | — | — | $0 | 0.00% |
| NONE | — | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| NONE | — | EYEMED VISION CARE | — | — | $0 | 0.00% |
| NONE | — | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORCORAN ADMINISTRATORS EIN 27-5364514 NONE | Plan Administrator; Other services Service code 14 | — | $516K |
| RAEL AND LETSON EIN 94-1701048 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $226K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing) Service code 10 | — | $127K |
| CIGNA - DENTAL PPO EIN 59-1031071 NONE | Direct payment from the plan Service code 50 | — | $43K |
| GILBERT & SACKMAN, A LAW CORP. EIN 95-2906951 NONE | Legal Service code 29 | — | $28K |
| MICHAEL SUROWITZ COMPLIANCE VERIFIC EIN 26-2336426 NONE | Accounting (including auditing) Service code 10 | — | $23K |
| SCOTT CAPITAL ADVISORS EIN 84-4636104 NONE | Securities brokerage; Direct payment from the plan Service code 33 | — | $20K |
| NAVITUS NONE | Direct payment from the plan; Insurance services Service code 23 | 1025 WEST NAVITUS DRIVE APPLETON, WI 54913 | $19K |
| VISION SERVICE PREMIUM EIN 94-1632821 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $19K |
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 | 1,076 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 410 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,486 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN | 2,050 | $20.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,381 | $270K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,587 | $238K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO | 882 | $40K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO | 882 | $40K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO | 882 | $40K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC STOP LOSS GROUP | 191 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,050 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.