| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 | 940 ADAMS ST STE G BENICIA, CA 94510 | RELIASTAR LIFE INSURANCE COMPANY | $28K | — | $28K | 5.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $474K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $90K |
| ANTHEM, INC. EIN 95-3760980 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $74K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $71K |
| MCMORGAN & COMPANY, LLC EIN 52-2334338 NONE | Investment management fees paid directly by plan Service code 51 | — | $69K |
| BEESON, TAYER & BODINE EIN 94-3126136 NONE | Legal; Direct payment from the plan Service code 29 | — | $37K |
| TEAMSTERS ASSISTANCE PROGRAM OF NC EIN 68-0048516 NONE | Other services; Direct payment from the plan Service code 49 | — | $28K |
| ZELIS CLAIMS INTEGRITY, LLC EIN 86-1040704 NONE | Other fees; Direct payment from the plan Service code 50 | — | $27K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 NONE | Claims processing; Direct payment from the plan; Other services Service code 12 | — | $14K |
| RUSSELL G. WOODSON, D.D.S. EIN 52-7115027 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $8K |
| TRUSTEE 1 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | 1600 HARBOR BAY PKWY STE 200 ALAMEDA, CA 94502 | $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 | 1,222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 122 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,478 | $17.9M |
| Dental(4 contracts, 3 carriers) | NEWPORT DENTAL PLAN | 142 | $122K |
| Vision | VISION SERVICE PLAN | 985 | $20K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,287 | $86K |
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 2,287 | $86K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 240 | $524K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 2,287 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,287 | — |
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.