| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES OF CA I | 2300 CONTRA COSTA BLVD STE 525 PLEASANT HILL, CA 94523 | UNITED STATES FIRE INSURANCE | $53K | — | $53K | 7.50% |
| XL BENEFIT INSURANCE SERVICES3 | 10471 GRANT LINE ROAD SUITE 100 ELK GROVE, CA 95624 | UNITED STATES FIRE INSURANCE | $35K | — | $35K | 5.00% |
| JOHN L WENDER INSURANCE SERVICES3 Filed as: JOHN LOUIS WENDER | 635 BARSTOW AVE STE 13 CLOVIS, CA 93611 | AMERITAS LIFE INSURANCE CORP | $5K | — | $5K | 20.40% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES OF CA I | 2300 CONTRA COSTA BLVD STE 525 PLEASANT HILL, CA 94523 | AMERITAS LIFE INSURANCE CORP | $4K | — | $4K | 15.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPASS HEALTH ADMINISTRATORS EIN 82-2891309 TPA | Recordkeeping fees; Consulting fees; Contract Administrator; Account maintenance fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 7625 N PALM AVE SUITE 101 FRESNO, CA 93711 | $97K |
| BLUE SHIELD OF CALIFORNIA EIN 94-0360524 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing; Contract Administrator Service code 12 | 50 BEALE STREET SAN FRANCISCO, CA 94105 | $97K |
| VALENZ CARE EIN 36-4869660 CASE MANAGEMENT | Other services Service code 49 | 22601 N 19TH AVE STE 131 PHOENIX, AZ 85027 | $27K |
| TEAMSTER ALCOHOL REHAB PROGRAM EIN 94-2875955 REHABILITATION ADMIN | Contract Administrator Service code 13 | 1620 N CARPENTER ROAD C-12 MODESTO, CA 95351 | $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 | 357 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 294 | $23K |
| Vision | VISION SERVICE PLAN | 296 | $39K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 357 | $24K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE | 297 | $703K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 357 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.