| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | P.O. BOX 997100 SACRAMENTO, CA 95899 | VISION SERVICE PLAN | — | $18K | $18K | 12.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREFERRED NETWORK ACCESS, INC EIN 36-4018433 NONE | Other services; Direct payment from the plan Service code 49 | — | $479K |
| STEWART C. MILLER & CO, INC EIN 35-1820020 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $269K |
| HINES & ASSOCIATES, INC EIN 36-3545085 NONE | Direct payment from the plan; Other services Service code 49 | — | $134K |
| FOSTER & FOSTER EIN 59-1921114 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $89K |
| D HIGBY EIN 35-0911491 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $88K |
| D SODERQUIST EIN 35-0911491 ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $71K |
| P HUFF EIN 35-0911491 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| HAGBERG & ASSOCIATES, P.C. EIN 01-0598991 NONE | Legal; Direct payment from the plan Service code 29 | — | $60K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $44K |
| GRAYSTONE CONSULTING EIN 26-4310632 NONE | Investment advisory (plan); Direct payment from the plan; Securities brokerage; Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $37K |
| J SWIDER EIN 35-0911491 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $34K |
| RED CARD EIN 20-5388701 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $28K |
| SAGE ADVISORY SERVICES LTD CO NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 5900 SOUTHWEST PARKWAY, BUILDING 1 AUSTIN, TX 78748 | $25K |
| SEGAL CONSULTING EIN 13-1975125 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $20K |
| FIRST MIDWEST BANK EIN 35-0210737 NONE | Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $8K |
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 | 884 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 474 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,017 | $149K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $50K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,012 | $730K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,017 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.