| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3000 EXECUTIVE SAN RAMON, CA 94583 | RELIASTAR LIFE INSURANCE COMPANY | $47K | — | $47K | 4.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACIFIC SOUTHWEST ADMINISTRATORS EIN 46-4942970 NONE | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | — | $245K |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $161K |
| ASB CAPITAL MANAGEMENT EIN 80-0618452 NONE | Investment management Service code 28 | — | $146K |
| EPIC BROKERS EIN 94-3195221 NONE | Consulting (general) Service code 16 | — | $125K |
| SEYFARTH SHAW EIN 36-2152202 NONE | Legal Service code 29 | — | $85K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $83K |
| GUARDIAN EIN 13-5123390 NONE | Claims processing Service code 12 | — | $60K |
| HORIZON ACTUARIAL SERVICES, LLC EIN 26-1370698 NONE | Consulting (general); Actuarial Service code 11 | — | $59K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment management; Investment advisory (plan) Service code 27 | — | $45K |
| HENNINGFIELD & ASSOCIATES, INC. EIN 54-2189926 NONE | Accounting (including auditing) Service code 10 | — | $31K |
| ENVISIONRXPLUS EIN 20-4308924 NONE | Claims processing Service code 12 | — | $25K |
| LEVY PHILLIPS EIN 47-3697177 NONE | Legal Service code 29 | — | $21K |
| WEST HEALTH ADVOCATE SOLUTIONS, INC EIN 23-3080019 NONE | Claims processing Service code 12 | — | $16K |
| PAUL HASTINGS, LLP EIN 95-2209675 NONE | Legal Service code 29 | — | $13K |
| US BANK EIN 31-0841368 NONE | Custodial (securities) Service code 19 | — | $11K |
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 | 587 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 281 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 868 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLANS INC. | 466 | $3.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 770 | $65K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 770 | $65K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 596 | $961K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 770 | — |
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.