| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EPIC3 | 12009 FOUNDATION PL STE 370 GOLD RIVER, CA 956704535 | SUTTER HEALTH PLAN | $29K | — | $29K | 1.97% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | WESTERN HEALTH ADVANTAGE | $15K | — | $15K | 1.22% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | WESTERN HEALTH ADVANTAGE & NATIONAL HEALTH INSURANCE COMPANY | $11K | — | $11K | 2.00% |
| HEALTH INSURANCE SERVICES3 | 5640 W MAPLE RD STE 304 WEST BLOOMDIELD, MI 48322 | UNITED AMERICAN INSURANCE COMPANY | $34K | — | $34K | 7.58% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing Service code 12 | — | $75K |
| DODGE & COX EIN 94-1441976 NONE | Investment management Service code 28 | — | $62K |
| ALICE MARSHALL EMPLOYEE | Employee (plan) Service code 30 | 2525 CLEVELAND AVE STE C SANTA ROSA, CA 95403 | $61K |
| SARAH PRADELS EMPLOYEE | Employee (plan) Service code 30 | 2525 CLEVELAND AVE STE C SANTA ROSA, CA 95403 | $49K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general) Service code 16 | — | $43K |
| TRUCKER HUSS, APC EIN 94-3216063 NONE | Legal Service code 29 | — | $39K |
| NAVIA BENEFIT SOLUTIONS EIN 91-1467758 NONE | Plan Administrator Service code 14 | — | $27K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | — | $23K |
| IBEW LOCAL 551 EIN 94-1104872 PARTY IN INTEREST | Direct payment from the plan Service code 50 | — | $15K |
| COMPLIANCE AUDIT SERVICES EIN 94-3134229 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| OPTUM RX EIN 94-3077084 NONE | Claims processing Service code 12 | — | $13K |
| SALTZMAN & JOHNSON LAW CORPORATION EIN 94-2376174 NONE | Legal Service code 29 | — | $7K |
| VINTAGE COMMUNICATIONS EIN 47-2450345 NONE | 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 | 490 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 84 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 574 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER PERMANENTE FOUNDATION HEALTH | 1,047 | $10.2M |
| Vision | VISION SERVICE PLAN | 581 | $48K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE CO | 489 | $7K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 198 | $1.9M |
| Other | UNITED OF OMAHA LIFE INSURANCE CO | 489 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,047 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.