No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LEGAL DEFENSE ADMINISTRATORS INC. EIN 45-3070832 | Direct payment from the plan; Contract Administrator Service code 13 | P O BOX 4859 SANTA ROSA, CA 95402 | $2.8M |
| SALTZMAN & JOHNSON EIN 94-2376174 | Legal; Direct payment from the plan Service code 29 | 44 MONTGOMERY STREET STE 211 SAN FRANCISCO, CA 94104 | $98K |
| FRED ROWBOTHAM TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | C/O LDA, P O BOX 4859 SANTA ROSA, CA 95402 | $74K |
| CROWELL & MORING LLP EIN 52-1150358 | Legal; Direct payment from the plan Service code 29 | 1001 PENNSYLVANIA AVE NW WASHINGTON, DC 20004 | $50K |
| PORAC LAW ENFORCEMENT NEWS EIN 94-2781391 | Direct payment from the plan; Participant communication Service code 38 | 4010 TRUXEL ROAD SACRAMENTO, CA 95834 | $38K |
| MOSS ADAMS LLP EIN 91-0189318 | Direct payment from the plan; Accounting (including auditing) Service code 10 | 2882 PROSPECT PARK DRIVE SUITE 300 RANCHO CORDOVA, CA 95670 | $38K |
| CVENT, INC. EIN 54-1954458 | Direct payment from the plan; Other services Service code 49 | 1765 GREENSBORO STATION PL 7TH FL MCLEAN, VA 22102 | $30K |
| PAYDEN & RYGEL EIN 95-3921788 | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management; Investment advisory (plan) Service code 27 | 333 SOUTH GRAND AVENUE STE 3200 LOS ANGELES, CA 90071 | $11K |
| P. CHRIS COULTER TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | C/O LDA, P O BOX 4859 SANTA ROSA, CA 95402 | $9K |
| DAVID WOZINIAK TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | C/O LDA, P O BOX 4859 SANTA ROSA, CA 95402 | $9K |
| DAVID J. REED, CPA EIN 45-3746634 | Consulting (general); Direct payment from the plan; Accounting (including auditing) Service code 10 | 2360 MORAN COURT AUBURN, CA 95603 | $7K |
| TODD FRAIZER TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | C/O LDA, P O BOX 4859 SANTA ROSA, CA 95402 | $6K |
| BARRY DONELAN TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | C/O LDA, P O BOX 4859 SANTA ROSA, CA 95402 | $5K |
| RENAKER HASSELMAN SCOTT LLP EIN 47-3126925 | Legal; Direct payment from the plan Service code 29 | 505 MONTGOMERY STREET, SUITE 1125 SAN FRANCISCO, CA 94111 | $5K |
| PAPERSTREET WEB DESIGN, INC. EIN 90-0118682 | Direct payment from the plan; Other services Service code 49 | 219 SW 17TH STREET FORT LAUDERDALE, FL 33315 | $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 | 142,931 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,028 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 143,959 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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.