| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSHA HAZLEWOOD3 | 2616 LAS COSTA AVENUE CARLSBAD, CA 92009 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | $56K | — | $56K | 1.50% |
| THE SEGAL COMPANY Filed as: SEGAL COMPANY (WESTERN STATES), INC | 100 MONTGOMERY ST, 5TH FL, STE. 500 SAN FRANCISCO, CA 941044308 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | — | $5K | $5K | 2.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHWEST ADMINISTRATORS, INC. EIN 91-0681697 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $750K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $234K |
| VIGIL VIRGINIA EIN 94-1206350 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $171K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Investment advisory (plan); Insurance services; Insurance brokerage commissions and fees; Consulting (general) Service code 16 | — | $148K |
| MCMORGAN AND COMPANY EIN 52-2334338 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $139K |
| BUILDING SKILLS PARTNERSHIP EIN 26-1254255 NONE | Other services; Direct payment from the plan Service code 49 | — | $123K |
| DARLENE RIVAS EIN 94-1206350 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $122K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $121K |
| DAVID VASQUEZ EIN 94-1206350 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $92K |
| MARITZA MARRUFO EIN 94-1206350 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| LETICIA CAAMANO EIN 94-1206350 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| ANALYN CAMANAG EIN 94-1206350 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| SALTZMAN AND JOHNSON EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $80K |
| WEINBERG, ROGER & ROSENFELD EIN 94-2458080 NONE | Legal; Direct payment from the plan Service code 29 | — | $78K |
| AABCO PRINTING EIN 94-1553665 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $67K |
| CHARLES GILCHRIST EIN 94-1206350 TRUSTEE | Direct payment from the plan; Trustee (individual); Named fiduciary Service code 20 | — | $59K |
| LARRY SMITH EIN 94-1206350 TRUSTEE | Trustee (individual); Named fiduciary; Direct payment from the plan Service code 20 | — | $55K |
| RAY NANN EIN 94-1206350 TRUSTEE | Trustee (individual); Named fiduciary; Direct payment from the plan Service code 20 | — | $53K |
| NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $27K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 NONE | Direct payment from the plan; Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $26K |
| SEGAL ADVISORS EIN 13-2646110 NONE | Investment advisory (plan); Consulting (pension); Direct payment from the plan Service code 17 | — | $26K |
| STEPHEN HORN EIN 94-3249244 NONE | Insurance brokerage commissions and fees Service code 53 | — | $25K |
| FARRELL FRITZ NONE | Investment management; Direct payment from the plan Service code 28 | 400 RXR PLAZA UNIONDALE, NY 11556 | $13K |
| IRON MOUNTAIN RECORDS NONE | Direct payment from the plan; Other services Service code 49 | 1000 CAMPUS DRIVE COLLEGEVILLE, PA 19426 | $11K |
| ALSTON & BIRD, LLP EIN 58-0137615 NONE | Legal; Direct payment from the plan Service code 29 | — | $11K |
| FIRST DENTAL HEALTH EIN 33-0655193 NONE | Other services; Direct payment from the plan Service code 49 | — | $11K |
| FREMONT BANK EIN 94-1569025 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $10K |
| PURCHASE POWER NONE | Other services; Direct payment from the plan Service code 49 | P.O. BOX 371874 PITTSBURGH, PA 152509874 | $7K |
| DE LAGE LANDEN NONE | Other services; Direct payment from the plan Service code 49 | 1111 OLD EAGLE SCHOOL ROAD WAYNE, PA 19087 | $6K |
| AT&T NONE | Other services; Direct payment from the plan Service code 49 | 5555 E OLIVE AVE FRESNO, CA 93727 | $6K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $5K |
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 | 10,386 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 86 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,472 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | 20,734 | $3.7M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 31,234 | $144K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | 107 | $184K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 10,071 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31,234 | — |
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.