| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIAN ULLRICH3 Filed as: BRIAN M ULLRICH | PO BOX 579258 MODESTO, CA 95357 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| BRIAN ULLRICH3 Filed as: BRIAN M ULLRICH | PO BOX 579258 MODESTO, CA 95357 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| BRIAN ULLRICH3 | PO BOX 400847 LAS VEGAS, NV 89140 | VSP | $2K | — | $2K | 3.26% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP, LLC | 18700 N. HAYDEN ROAD SUITE 405 SCOTTSDALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | $3K | $4K | $7K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRISTAR BENEFIT ADMINISTRATORS EIN 38-3739503 | Claims processing Service code 12 | 12257 UNIVERSITY STE 200 CLIVE, IA 50325 | $187K |
| S&S HEALTHCARE STRATEGIES, LTD EIN 31-1418743 | Other services Service code 49 | 1385 KEMPER MEADOW DR CINCINNATI, OH 45240 | $93K |
| TRISTAR MANAGED CARE EIN 95-4824593 | Other services Service code 49 | — | $22K |
| MDLIVE EIN 27-0982413 | Other services Service code 49 | — | $9K |
| CONNECTION DENTAL EIN 43-1796335 | Other services Service code 49 | — | $5K |
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 | 743 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 749 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 377 | $393K |
| Vision | VSP | 423 | $63K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 743 | $264K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 743 | $264K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 774 | $170K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 377 | $393K |
| Other | HCC LIFE INSURANCE COMPANY | 370 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 774 | — |
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.