| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | BLUE SHIELD OF CALIFORNIA | $0 | $202K | $202K | 1.26% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | — | KAISER FOUNDATION HEALTH PLAN INC. | $129K | — | $129K | 1.49% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | — | DELTA DENTAL OF CALIFORNIA | $88K | — | $88K | 3.15% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | — | VISION SERVICE PLAN | $22K | — | $22K | 4.63% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | — | KAISER FOUNDATION HEALTH PLAN INC. | $5K | — | $5K | 1.74% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | — | THE UNION LABOR LIFE INSURANCE CO. | $21K | — | $21K | 10.00% |
| R.L. MILSNER INC.3 Filed as: R.L. MILSNER AND CO | — | GUARDIAN LIFE INSURANCE CO OF AMERICA | $963 | — | $963 | 14.20% |
| WILLNER-CARDINET-KIDWELL3 | — | GUARDIAN LIFE INSURANCE CO OF AMERICA | $19 | — | $19 | 0.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LAW FIRM OF JAMES P. BAKER EIN 87-3996649 NONE | Legal; Direct payment from the plan Service code 29 | — | $121K |
| ZENITH AMERICAN SOLUTIONS NONE | Direct payment from the plan; Contract Administrator Service code 13 | 1600 HARBOR BAY PARKWAY, STE 200 ALAMEDA, CA 94502 | $104K |
| MARIA RIVERA EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $93K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $59K |
| STEPHANIE GUERRA EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $47K |
| JILLIAN BAIRES EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $45K |
| TINA FAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $45K |
| CONCETTA DIFRANCIA CRUZ EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $41K |
| KATIE RAVETTI EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $35K |
| WILLIAM OLINGER EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $31K |
| RAEL & LETSON NONE | Accounting (including auditing); Consulting (general) Service code 10 | 2929 CAMPUS DRIVE, SUITE 400 SAN MATEO, CA 94403 | $27K |
| ROBERT WEINSTEIN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $27K |
| MORGAN STANLEY EIN 20-8754829 NONE | Other investment fees and expenses; Other commissions; Direct payment from the plan; Custodial (securities); Securities brokerage commissions and fees; Other services; Investment advisory (plan); Securities brokerage Service code 19 | — | $26K |
| PRO PRINT EIN 94-3160648 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $25K |
| BANK OF AMERICA EIN 93-6207280 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $24K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $23K |
| RL MILSNER EIN 94-2494656 NONE | Insurance brokerage commissions and fees Service code 53 | — | $19K |
| SEGAL BRYANT & HAMILL EIN 41-1788385 NONE | Investment management; Direct payment from the plan Service code 28 | — | $18K |
| UMA EIN 20-8764829 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $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 | 1,182 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 204 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 1,864 | $26.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,289 | $2.8M |
| Vision | VISION SERVICE PLAN | 1,223 | $471K |
| Life insurance(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE CO. | 1,243 | $219K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 1,864 | $17.8M |
| Other(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE CO. | 1,243 | $219K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,864 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.