| Provider | Services | Address | Compensation |
|---|---|---|---|
| UFCW GROUP ADMINISTRATION LLC EIN 26-0048379 PARTY IN INTEREST | Contract Administrator; Direct payment from the plan Service code 13 | — | $1.0M |
| BLUE SHIELD OF CALIFORNIA EIN 94-0360524 NONE | Claims processing; Direct payment from the plan Service code 12 | 3401 N. CENTRE LAKE DR. 400 ONTARIO, CA 91761 | $371K |
| JOHN COHENOUR EIN 68-0237301 NONE | Legal; Direct payment from the plan Service code 29 | — | $132K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $70K |
| MEDEXPERT EIN 94-3360248 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $62K |
| HEALTH MANAGEMENT CONCEPTS NONE | Direct payment from the plan; Plan Administrator Service code 14 | 140 INTRACOASTAL POINTE DR STE 301 JUPITER, FL 33477 | $52K |
| PREMIER ACCESS DENTAL NONE | Direct payment from the plan Service code 50 | 8890 CAL CENTER DRIVE SACRAMENTO, CA 95826 | $40K |
| UFCW LOCAL 5 EIN 20-8028546 PARTY IN INTEREST | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $26K |
| BENEFIT AND RISK MANAGEMENT SERVICE NONE | Direct payment from the plan Service code 50 | 80 IRON POINT CIRCLE, SUITE 200 FOLSOM, CA 95630 | $25K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $24K |
| HS TECHNOLOGY EIN 27-1818792 NONE | Direct payment from the plan Service code 50 | — | $24K |
| RV KUHNS EIN 93-0910652 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $23K |
| UFCW LOCAL 8 EIN 94-0801845 PARTY IN INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $19K |
| PODIATRY PLAN, INC. NONE | Direct payment from the plan; Plan Administrator Service code 14 | 203 WILLOW ST SAN FRANCISCO, CA 94109 | $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 | 2,384 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 286 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,670 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | RELIASTAR LIFE INSURANCE COMPANY | 2,120 | $436K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,120 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.