| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SVCS INC. | 940 ADAMS STREET BENICIA, CA 94510 | NATIONAL UNION FIRE INS CO OF PITTSBURGH PA | $9K | — | $9K | 14.50% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S FIGUEROA STREET FL 35 LOS ANGELES, CA 90017 | VISION SERVICE PLAN | $2K | — | $2K | 3.33% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET FL 12 SAN FRANCISCO, CA 94111 | VISION SERVICE PLAN | $388 | — | $388 | 0.82% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S FIGUEROA STREET FL 35 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 18.18% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET FL 12 SAN FRANCISCO, CA 94111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $481 | — | $481 | 1.27% |
| WOODRUFF-SAWYER & CO3 | 220 BUSH STREET 7TH FLOOR SAN FRANCISCO, CA 94104 | TRANSAMERICA LIFE INSURANCE COMPANY | $7K | — | $7K | 35.20% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S FIGUEROA STREET FL 35 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.45% |
| WOODRUFF-SAWYER & CO3 | 220 BUSH STREET 7TH FLOOR SAN FRANCISCO, CA 94104 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | — | $4K | 48.41% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S FIGUEROA STREET FL 35 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $297 | $297 | 6.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT & RISK MANAGEMENT SERVICES, EIN 68-0306908 | Direct payment from the plan; Claims processing Service code 12 | 80 IRON POINT CIRCLE SUITE 200 FOLSOM, CA 95630 | $249K |
| MAXOR PLUS EIN 75-2676894 | Claims processing; Direct payment from the plan Service code 12 | 320 SOUTH POLK STREET STE 200 AMARILLO, TX 79101 | $96K |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 | Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $93K |
| POMCO, INC. EIN 15-0381548 | Direct payment from the plan; Claims processing Service code 12 | 2425 JAMES STREET SYRACUSE, NY 13206 | $48K |
| INTERACTIVE HEALTH EIN 36-3798756 | Other services; Direct payment from the plan Service code 49 | 11409 CRONHIHLL DRIVE SUITE M OWINGS MILLS, MD 21117 | $34K |
| CLIFTON LARSEN ALLEN LLP EIN 41-0746749 | Direct payment from the plan; Accounting (including auditing) Service code 10 | 925 HIGHLAND POINTE DR SUITE 450 ROSEVILLE, CA 95678 | $25K |
| IGOE ADMINISTRATIVE SERVICES EIN 95-3391660 | Contract Administrator; Direct payment from the plan Service code 13 | P O BOX 501480 SAN DIEGO, CA 92150 | $12K |
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 | 429 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 430 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | VISION SERVICE PLAN | 248 | $59K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 430 | $16K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 324 | $725K |
| Other(7 contracts, 4 carriers) | NATIONAL UNION FIRE INS CO OF PITTSBURGH PA | 430 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 430 | — |
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.