| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN | — | — | $0 | 0.00% |
| NONE | — | BLUE SHIELD OF CALIFORNIA | — | — | $0 | 0.00% |
| CHARLIE CROUSE3 | 3712 SOUTHWOOD AVE SAN MATEO, CA 94403 | CHINESE COMMUNITY HOSPITAL | $127K | — | $127K | 4.00% |
| NONE | — | HEALTH NET | — | — | $0 | 0.00% |
| NONE | — | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| RAEL & LETSON3 | 378 VINTAGE PARK DRIVE FOSTER CITY, CA 944044813 | UNITED HEALTHCARE | $5K | — | $5K | 1.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ATPA EIN 94-3187938 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $692K |
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $427K |
| L. RUSH EIN 94-1645611 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| RAEL & LETSON EIN 94-1524115 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $100K |
| LEONARD, ET. AL EIN 94-2819269 NONE | Legal; Direct payment from the plan Service code 29 | — | $93K |
| INCOME RESEARCH MANAGEMENT NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 100 FEDERAL STREET, 30TH FLOOR BOSTON, MA 02110 | $61K |
| HUA YUE MAI EIN 94-1645611 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| SELF HELP FOR THE ELDERLY EIN 94-1750717 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $52K |
| ANA SABORIO EIN 94-1645611 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| ASCENDENT HEALTHCARE NONE | Other services; Direct payment from the plan Service code 49 | 1755 INDIAN WOOD CIRCLE MAUMEE, OH 43537 | $41K |
| KAPLAN 12 LEARNING NONE | Consulting (general); Direct payment from the plan Service code 16 | 1 LIBERTY PLAZA, 22ND FLOOR NEW YORK, NY 10006 | $35K |
| HEMMING MORSE EIN 30-0702322 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $33K |
| PAULETTE MCMILLAN EIN 80-0669079 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $31K |
| NEW ENGLAND PENSION CONSULTANTS EIN 04-2927339 NONE | Direct payment from the plan; Investment management Service code 28 | — | $21K |
| PAUL GEHRMAN NONE | Consulting (general); Direct payment from the plan Service code 16 | 430 ELM AVE. LARKSPUR, CA 94939 | $7K |
| BITTNER & CO. EIN 94-3052455 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $6K |
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 | 7,654 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,500 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE SHIELD OF CALIFORNIA | 4,284 | $31.4M |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 7,998 | $2.1M |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 4,284 | $26.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 17,714 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.