No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SEDGWICK CLAIMS MGMT SERVICES EIN 36-2685608 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $630K |
| HEALTHPLAN SERVICES, INC. EIN 59-1407300 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $310K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 NONE | Other services; Float revenue; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $268K |
| GROOM LAW GROUP, CHARTERED EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $123K |
| ALLSUP, LLC EIN 82-2208506 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $96K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 NONE | Direct payment from the plan; Consulting fees; Actuarial; Consulting (general) Service code 11 | — | $79K |
| BREGE COMMUNICATIONS, INC EIN 47-3081862 NONE | Direct payment from the plan; Participant communication; Consulting fees; Consulting (general) Service code 16 | — | $57K |
| BANK OF NEW YORK MELLON EIN 13-5160382 TRUSTEE/ CUSTODIAN | Other investment fees and expenses; Other fees; Trustee (directed); Float revenue; Direct payment from the plan; Shareholder servicing fees Service code 25 | — | $47K |
| MOSS ADAMS LLP EIN 91-0189318 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $44K |
| MERCER HEALTH & BENEFITS LLC EIN 34-2015463 NONE | Consulting fees; Actuarial; Insurance agents and brokers; Consulting (general); Direct payment from the plan Service code 11 | — | $38K |
| BLACKROCK INSTITUTIONAL TRUST CO. EIN 94-3112180 NONE | Investment management fees paid indirectly by plan; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Investment management; Investment management fees paid directly by plan; Trustee (discretionary) Service code 21 | — | $37K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 NONE | Claims processing; Plan Administrator; Direct payment from the plan Service code 12 | — | $34K |
| LIFEWORKS (US) LTD. EIN 52-1883918 NONE | Direct payment from the plan; Recordkeeping fees; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $33K |
| VALUEOPTIONS, INC. EIN 54-1414194 NONE | Insurance services; Contract Administrator; Direct payment from the plan Service code 13 | — | $27K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $21K |
| STUDIO 19.US, INCORPORATED EIN 87-0700041 NONE | Participant communication; Direct payment from the plan Service code 38 | — | $16K |
| SOVOS COMPLIANCE, LLC EIN 46-1379693 NONE | Other services; Direct payment from the plan Service code 49 | — | $16K |
| MADISON STREET PRESS EIN 94-2977418 NONE | Direct payment from the plan; Other services Service code 49 | — | $16K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $7K |
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 | 515 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 515 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 177 | $353K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 177 | $353K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.