| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES, INC | 940 ADAMS ST STE G BENICIA, CA 94510 | NATIONAL UNION FIRE INSURANCE CO. OF PA | $28K | — | $28K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Float revenue; Claims processing; Other fees Service code 12 | — | $482K |
| ZENITH AMERICAN SOLUTIONS, INC EIN 52-1590516 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $454K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $99K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 NONE | Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $61K |
| BEESON, TAYER & BODINE, APC EIN 94-3126136 NONE | Legal; Direct payment from the plan Service code 29 | — | $60K |
| MCMORGAN & COMPANY, LLC EIN 52-2334338 NONE | Investment management fees paid directly by plan Service code 51 | — | $52K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $51K |
| TEAMSTERS ASSISTANCE PROGRAM EIN 68-0048516 NONE | Other services; Direct payment from the plan Service code 49 | — | $25K |
| RUSSELL G. WOODSON, D.D.S. EIN 52-7115027 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $8K |
| FREMONT BANK EIN 94-1569025 NONE | Other services; Direct payment from the plan Service code 49 | — | $7K |
| ZELIS CLAIMS INTEGRITY, LLC EIN 86-1040704 NONE | Direct payment from the plan Service code 50 | — | $6K |
| FIDELITY INVESTMENTS INSTITUTIONAL EIN 04-2647786 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $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 | 1,203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 119 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,390 | $17.0M |
| Dental(4 contracts, 3 carriers) | NEWPORT DENTAL PLAN | 149 | $125K |
| Vision | VISION SERVICE PLAN | 1,037 | $21K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 0 | $83K |
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 0 | $83K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INSURANCE CO. OF PA | 230 | $562K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 0 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,390 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.