No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 11-2581812 NONE | Claims processing Service code 12 | — | $924K |
| BLUE SHIELD OF CALIFORNIA NONE | Claims processing Service code 12 | 100 N SEPULVEDA BLVD 20TH FL EL SEGUNDO, CA 90245 | $129K |
| RAEL AND LETSON EIN 94-1701048 NONE | Actuarial Service code 11 | — | $99K |
| CHRIS MCDANIEL EE. OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $67K |
| INNOVATIVE SOFTWARE SOLUTIONS INC. NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 3000 S LENOLA RD MAPLE SHADE, NJ 08052 | $54K |
| BELINDA HIBBARD EE. OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $50K |
| ALISA MUELLER EE. OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $49K |
| BRAD BERNEL EE. OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $49K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | — | $45K |
| CONNIE HIBBARD EE. OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $43K |
| ALEXAN RPM, INC. NONE | Other services Service code 49 | 1232 Q ST 2ND FL SACRAMENTO, CA 95811 | $42K |
| UNITED CONCORDIA NONE | Claims processing Service code 12 | 2950 BUSKIRK AVE STE 300 WALNUT CREEK, CA 94597 | $31K |
| ISLIP & CO. EIN 68-0344156 NONE | Accounting (including auditing) Service code 10 | — | $30K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing) Service code 10 | — | $18K |
| UNION BANK EIN 94-0304228 NONE | Trustee (bank, trust company, or similar financial institution); Other services Service code 21 | — | $16K |
| MESVISION NONE | Claims processing Service code 12 | PO BOX 25209 SANTA ANA, CA 92799 | $7K |
| KRAW & KRAW EIN 32-0465891 NONE | Legal Service code 29 | — | $7K |
| MERRILL LYNCH PIERCE FENNER SMITH EIN 13-5674085 NONE | Sub-transfer agency fees; Distribution (12b-1) fees Service code 60 | — | $0 |
| STEPHEN HORN INSURANCE SERVICES EIN 94-3249244 NONE | Insurance brokerage commissions and fees Service code 53 | — | $0 |
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 | 579 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 166 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 44 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 33 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 822 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS, INC | 1,018 | $6.4M |
| Dental(3 contracts) | DELTA DENTAL OF CALIFORNIA | 86 | $79K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMP | 622 | $55K |
| Stop-loss / reinsurancereinsurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 378 | $611K |
| Other | THE UNION LABOR LIFE INSURANCE COMP | 622 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,018 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.