| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing; Direct payment from the plan Service code 12 | 100 FIRST STREET M/S 6D SAN FRANCISCO, CA 94105 | $64K |
| ALICE MARSHALL EIN 23-7071451 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 2525 CLEVELAND AVE SANTA ROSA, CA 95403 | $43K |
| RAEL & LETSON, INC. EIN 94-2561452 NONE | Consulting (general); Direct payment from the plan Service code 16 | 2800 CAMPUS DRIVE SUITE 150 SAN MATEO, CA 94403 | $40K |
| SARAH MILLER EIN 23-7071451 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 2525 CLEVELAND AVE SANTA ROSA, CA 94503 | $32K |
| HEMMING MORSE, LLP EIN 30-0702322 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $23K |
| DODGE & COX EIN 94-1441976 NONE | Investment advisory (plan); Investment management fees paid directly by plan; Investment management Service code 27 | 555 CALIFORNIA STREET SAN FRANCISCO, CA 94104 | $22K |
| IBEW LOCAL 551 BUILDING CORP EIN 68-0408960 PARTY IN INTEREST | Direct payment from the plan; Other fees Service code 50 | — | $14K |
| COMPLIANCE AUDIT SERVICES EIN 94-3134229 NONE | Accounting (including auditing) Service code 10 | — | $13K |
| TRUCKER HUSS EIN 94-3216063 NONE | Direct payment from the plan; Legal Service code 29 | ONE EMBARCADERO CENTER, 12TH FLOOR SAN FRANCISCO, CA 94111 | $12K |
| SUE CAMPBELL NONE | Direct payment from the plan; Legal Service code 29 | 1155 N. FIRST ST., SUITE 218 SAN JOSE, CA 95112 | $9K |
| EXCHANGE BANK EIN 94-0463800 NONE | Custodial (securities); Direct payment from the plan Service code 19 | P.O. BOX 208 SANTA ROSA, CA 95402 | $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 | 431 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 81 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 512 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 0 | $0 |
| Vision | VISION SERVICE PLAN | 516 | $43K |
| Life insurance | UNITED OF OMAHA | 431 | $6K |
| Other | U.S. BEHAVIORAL HEALTH PLAN, CALIFORNIA DBA OPTUM | 431 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 897 | — |
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 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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.