Filings through .
History & trajectory Charts need 2 or more years. This plan has 8 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingBroker 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 |
|---|---|---|
Broker: None Health | Health | |
Broker: Interremedy Insurances Services LLC Stop-loss | Stop-loss | |
Life | Life | |
Dental | Dental |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 5 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 | 1,587 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,587 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 872 | $6.8M |
| Dental | LIBERTY DENTAL PLAN OF CALIFORNIA, INC | 7 | $1K |
| Life insurance(2 contracts) | PRUDENTIAL | 2,953 | $126K |
| Stop-loss / reinsurancereinsurance | THE NORTH RIVER INSURANCE COMPANY | 1,116 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,953 | - |
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 |
|---|---|
None Carrier: Kaiser Foundation Health Plan Inc | |
Carrier: The North River Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UFCW GROUP ADMINISTRATION LLC EIN 26-0048379 SALARIED ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $1.1M |
| BLUE SHIELD OF CALIFORNIA EIN 94-0360524 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $247K |
| HORIZON ACTUARIAL SERVICES, LLC EIN 26-1370698 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $102K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $95K |
| SEYFARTH & SHAW EIN 36-2152202 NONE | Legal; Direct payment from the plan Service code 29 | — | $90K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $86K |
| SOLIDARITUS HEALTH EIN 87-3068107 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $64K |
| MEDIMPACT HEALTHCARE SYSTEMS EIN 33-0567651 NONE | Direct payment from the plan; Other services Service code 49 | — | $43K |
| DELTA DENTAL EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $39K |
| MEDEXPERT INTERNATIONAL EIN 94-3360248 NONE | Direct payment from the plan; Other services Service code 49 | — | $38K |
| QUEST DIAGNOSTICS EIN 20-1908041 NONE | Direct payment from the plan; Other services Service code 49 | — | $37K |
| UFCW UNION LOCAL 5 EIN 20-8028546 SPONSOR | Direct payment from the plan; Other services Service code 49 | — | $24K |
| CYPRESS DENTAL EIN 68-0441908 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $20K |
| MCCRACKEN, STEMMERMAN & HOLLSBERRY EIN 94-1709555 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| UFCW UNION LOCAL 8 EIN 94-0801845 SPONSOR | Direct payment from the plan; Other services Service code 49 | — | $17K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $16K |
| JACE MARKETING SOLUTIONS EIN 27-2412041 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $5K |
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.
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8 filings · 2018 to 2025