| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHERN CA CEMENT MASONS ADMIN EIN 94-1583754 PARTY-IN-INTEREST | Plan Administrator; Direct payment from the plan Service code 14 | — | $864K |
| ANTHEM BLUE CROSS OF CA EIN 95-3760980 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Direct payment from the plan; Float revenue; Contract Administrator Service code 12 | — | $368K |
| SEGAL COMPANY EIN 94-1503999 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $180K |
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $130K |
| WEINBERG EIN 94-2458080 NONE | Legal; Direct payment from the plan Service code 29 | — | $90K |
| BULLIVANT HOUSER & BAILEY EIN 93-6246493 NONE | Legal; Direct payment from the plan Service code 29 | — | $71K |
| QUEST DIAGNOSTICS NONE | Other services; Direct payment from the plan Service code 49 | 10101 RENNER BLVD. LENEXA, KS 66219 | $53K |
| MCMORGAN EIN 52-2334338 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $50K |
| PACIFIC HEALTH ALLIANCE EIN 94-3010573 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $40K |
| HEMMING MORSE EIN 30-0702322 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $28K |
| VISION SERVICES EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $27K |
| OPTUMRX EIN 33-0441200 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $23K |
| E-PLAN NONE | Direct payment from the plan; Other services Service code 49 | 22601 N. 19TH AVE. STE 202 PHOENIX, AZ 85027 | $6K |
| J. GLYNN & COMPANY EIN 20-1686722 NONE | Direct payment from the plan Service code 50 | — | $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 | 2,014 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 567 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,581 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 325 | $57K |
| Dental | DELTA DENTAL OF CALIFORNIA | 137 | $21K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,525 | $305K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,421 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.