| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EPIC3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 941042215 | KAISER PERMANENTE FOUNDATION HEALTH | $90K | — | $90K | 1.46% |
| EPIC3 | 10877 WHITE ROCK RD STE 300 RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $30K | — | $30K | 2.01% |
| EPIC | 10877 WHITE ROCK RD STE 300 RANCHO CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE & NATIONAL HEALTH INSURANCE COMPANY | $12K | — | $12K | 2.00% |
| CONNELL, JOHN F Filed as: CONNELL, JOHN F. | 10877 WHITE ROCK RD STE 300 RANCHO CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE | $11K | — | $11K | 1.85% |
| HEALTH INSURANCE SERVICES3 | 5640 W MAPLE RD STE 304 WEST BLOOMDIELD, MI 48322 | UNITED AMERICAN INSURANCE COMPANY | $36K | — | $36K | 8.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALICE MARSHALL EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 2525 CLEVELAND AVE STE C SANTA ROSA, CA 95403 | $86K |
| SARAH PRADELS EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 2525 CLEVELAND AVE STE C SANTA ROSA, CA 95403 | $70K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $43K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $36K |
| DODGE & COX EIN 94-1441976 NONE | Investment management; Direct payment from the plan Service code 28 | — | $32K |
| NAVIA BENEFIT SOLUTIONS EIN 91-1467758 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $26K |
| NEYHART, ANDERSON, FLYNN & GROSBOLL NONE | Legal; Direct payment from the plan Service code 29 | 369 PINE ST #800 SAN FRANCISCO, CA 94104 | $25K |
| COMPLIANCE AUDIT SERVICES EIN 94-3134229 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $19K |
| IBEW LOCAL 551 EIN 94-1104872 RELATED PTY | Direct payment from the plan Service code 50 | — | $15K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $9K |
| VINTAGE COMMUNICATIONS EIN 47-2450345 NONE | Direct payment from the plan; Other services Service code 49 | — | $9K |
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 | 429 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 88 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 517 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | KAISER PERMANENTE FOUNDATION HEALTH | 925 | $9.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,300 | $0 |
| Vision | VISION SERVICE PLAN | 516 | $44K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE CO | 425 | $6K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 186 | $1.9M |
| Other | UNITED OF OMAHA LIFE INSURANCE CO | 425 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,300 | — |
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."
No prospect flags tripped on this filing.