| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 18940 N PIMA RD STE 210 SCOTTSDALE, AZ 85255 | AMWINS(RELIASTAR LIFE INSURANCE CO) | $68K | $0 | $68K | 5.00% |
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | AMWINS(RELIASTAR LIFE INSURANCE CO) | $34K | $0 | $34K | 2.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE SHIELD OF CALIFORNIA EIN 94-0360524 NONE | Claims processing Service code 12 | — | $151K |
| RAEL AND LETSON EIN 94-1701048 NONE | Consulting (general); Actuarial Service code 11 | — | $87K |
| CHRIS MCDANIEL EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $87K |
| UNITED CONCORDIA EIN 25-1688758 NONE | Claims processing Service code 12 | — | $78K |
| MESVISION EIN 95-4354242 NONE | Claims processing Service code 12 | — | $65K |
| BRAD BERNEL EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $65K |
| ALISA MUELLER EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $65K |
| CONNIE HIBBARD EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $64K |
| MICHELLE PERRY EMPLOYEE OF AFFIL. TRUST | Plan Administrator Service code 14 | 5841 NEWMAN CT SACRAMENTO, CA 95819 | $62K |
| CALIBER NETWORKS EIN 27-2155341 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $47K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $41K |
| BRIDGEWAY BENEFIT TECHNOLOGIES NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 3700 KOPPERS ST STE 400 BALTIMORE, MD 21227 | $29K |
| WITHUM EIN 22-2072092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $28K |
| ISLIP & CO. EIN 68-0344156 NONE | Accounting (including auditing) Service code 10 | — | $24K |
| KRAW LAW GROUP, APC EIN 32-0465891 NONE | Legal Service code 29 | — | $23K |
| INNOVATIVE SOFTWARE SOLUTIONS INC. EIN 23-2182079 NONE | Other fees Service code 99 | — | $20K |
| VICTOR X BERTOLANI NONE | Legal Service code 29 | 8801 FOLSOM BLVD STE 192 SACRAMENTO, CA 95826 | $6K |
| MERRILL LYNCH PIERCE FENNER & SMITH EIN 13-5674085 NONE | Custodial (other than securities); Distribution (12b-1) fees; Sub-transfer agency fees Service code 18 | — | $65 |
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 | 877 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 250 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS, INC | 1,557 | $12.8M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 158 | $77K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMP | 957 | $83K |
| Stop-loss / reinsurancereinsurance | AMWINS(RELIASTAR LIFE INSURANCE CO) | 523 | $1.4M |
| Other | THE UNION LABOR LIFE INSURANCE COMP | 957 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,557 | — |
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.