| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN INC | — | — | $0 | 0.00% |
| STOP LOSS INSURANCE SERVICES, INC. | 940 ADAMS ST, STE G BENICIA, CA 94510 | HCC LIFE INSURANCE COMPANY | $35K | — | $35K | 5.00% |
| NONE | — | UNITEDHEALTHCARE OF CALIFORNIA | — | — | $0 | 0.00% |
| NONE | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | DELTA DENTAL OF CALIFORNIA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $302K |
| LINDQUIST NONE | Direct payment from the plan Service code 50 | 5000 EXECUTIVE PKWY STE 400 SAN RAMON, CA 94583 | $132K |
| RAEL & LETSON EIN 94-1457076 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $71K |
| BLUE CROSS EIN 95-3760980 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $67K |
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $56K |
| SALTZMAN & JOHNSON LAW CORP NONE | Legal; Direct payment from the plan Service code 29 | 44 MONTGOMERY STREET, SUITE 2110 SAN FRANCISCO, CA 94104 | $56K |
| KRAW LAW GROUP EIN 77-0171216 NONE | Direct payment from the plan; Legal Service code 29 | — | $44K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $23K |
| ATALANTA SOSNOFF CAPITAL, LLC NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 101 PARK AVE NEW YORK, NY 10178 | $10K |
| VISION SERVICE PLAN EIN 13-2770433 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $9K |
| SEGALL BRYANT & HAMILL EIN 41-1788385 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $9K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $7K |
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 | 561 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 43 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 604 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 88 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 537 | $19K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 235 | $706K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 537 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,155 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.