Filings through .
History & trajectory Charts need 2 or more years. This plan has 10 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingThe primary broker changed. The plan may listen to a new pitch.
Broker comp is under 1% of premium on a plan over $1M. The plan may have no broker or pay a flat fee. Consultants can pitch it.
Premium per covered life exceeds 2x the peer median for this NAICS and size cohort. The plan has rich benefits or a bad rate.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Health | Health | |
Broker: Benefits America Insurance Services Dental | Dental | |
Vision | Vision |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 4 contracts with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 832 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 832 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 660 | $7.4M |
| Dental | GUARDIAN | 456 | $178K |
| Vision | VISION SERVICE PLAN | 442 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 660 | - |
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 instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions |
|---|---|
Carrier: Guardian |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MVI ADMINISTRATORS INSURANCE INC EIN 33-0393692 NONE | Plan Administrator Service code 14 | 2615 CAMINO DEL RIO SOUTH SUITE 201 SAN DIEGO, CA 92108 | $380K |
| INSURANCE OFFICE OF AMERICA INC EIN 59-2472656 NONE | Insurance agents and brokers Service code 22 | 3281 E GUASTI ROAD STE 400 ONTARIO, CA 91761 | $159K |
| NEWFRONT INSURANCE SERVICES LLC EIN 83-1773439 NONE | Insurance agents and brokers Service code 22 | 777 MARINERS ISLAND BLVD SUITE 250 SAN MATEO, CA 94404 | $49K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing) Service code 10 | PO BOX 88678 MILWAUKEE, WI 532888678 | $27K |
| HUB INTERNATIONAL INSURANCE SERVICE EIN 33-0315047 NONE | Insurance agents and brokers Service code 22 | 4695 MACARTHUR COURT STE 600 NEWPORT BEACH, CA 92626 | $20K |
| KENNETH KYLE SHALLAHAMER NONE | Consulting (general) Service code 16 | 15204 DAVENPORT ST TUSTIN, CA 92782 | $14K |
| SHEPPARD MULLIN RICHTER & HAMPTON EIN 95-1463164 NONE | Legal Service code 29 | PO BOX 840728 LOS ANGELES, CA 900840728 | $13K |
| ACRISURE LLC DBA BEAL INSURANCE EIN 26-3554645 NONE | Insurance agents and brokers Service code 22 | PO BOX 1788 GRAND RAPIDS, MI 490511788 | $7K |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
2 contacts
11 filings · 2015 to 2025