| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC. | 18940 NORTH PIMA RD., SUITE 210 SCOTTSDALE, AZ 85255 | AMWINS | $48K | — | $48K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RAEL AND LETSON EIN 94-1701048 NONE | Consulting (pension); Actuarial Service code 11 | — | $82K |
| CHRIS MCDANIEL EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN COURT SACRAMENTO, CA 95819 | $78K |
| UNITED CONCORDIA EIN 25-1688758 NONE | Claims processing Service code 12 | — | $66K |
| BELINDA HIBBARD EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN COURT SACRAMENTO, CA 95819 | $59K |
| BRAD BERNEL EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN COURT SACRAMENTO, CA 95819 | $57K |
| CONNIE HIBBARD EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN COURT SACRAMENTO, CA 95819 | $56K |
| ALISA MUELLER EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN COURT SACRAMENTO, CA 95819 | $56K |
| INNOVATIVE SOFTWARE SOLUTIONS INC. EIN 23-2182079 NONE | Other fees Service code 99 | — | $51K |
| CALIBER NETWORKS EIN 27-2155341 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $50K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | — | $38K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $28K |
| MERRILL LYNCH PIERCE FENNER & SMITH EIN 13-5674085 NONE | Sub-transfer agency fees; Distribution (12b-1) fees Service code 60 | — | $24K |
| ISLIP & CO. EIN 68-0344156 NONE | Accounting (including auditing) Service code 10 | — | $18K |
| KRAW LAW GROUP, APC EIN 32-0465891 NONE | Legal Service code 29 | — | $15K |
| OPTUMRX EIN 33-0441200 NONE | Float revenue; Other fees; Direct payment from the plan Service code 50 | — | $12K |
| MESVISION EIN 95-4354242 NONE | Claims processing Service code 12 | — | $10K |
| VICTOR X. BERTOLANI NONE | Legal Service code 29 | 1731 J STREET, STE 250 SACRAMENTO, CA 95811 | $7K |
| STEPHEN HORN INSURANCE SERVICES EIN 94-3249244 NONE | Soft dollars commissions; Insurance brokerage commissions and fees Service code 53 | — | $4K |
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 | 874 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 236 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS, INC | 1,561 | $9.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 134 | $70K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMP | 914 | $77K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AMWINS | 1,242 | $950K |
| Other | THE UNION LABOR LIFE INSURANCE COMP | 914 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,561 | — |
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.