| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 | 940 ADAMS ST STE G BENICIA, CA 94510 | HCC LIFE INSURANCE COMPANY | $40K | — | $40K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $477K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | — | $104K |
| PREMIER ACCESS NONE | Direct payment from the plan; Claims processing Service code 12 | PO BOX 659020 SACRAMENTO, CA 95865 | $95K |
| MCMORGAN & COMPANY, LLC EIN 52-2334338 NONE | Investment management fees paid directly by plan Service code 51 | — | $79K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $64K |
| BEESON, TAYER & BODINE EIN 94-3126136 NONE | Legal; Direct payment from the plan Service code 29 | — | $62K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $55K |
| TEAMSTERS ASSIST PROGRAM EIN 68-0048516 NONE | Direct payment from the plan; Other services Service code 49 | — | $28K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | — | $17K |
| ZELIS CLAIMS INTEGRITY, LLC EIN 86-1040704 NONE | Other fees; Direct payment from the plan Service code 50 | — | $14K |
| FREMONT BANK EIN 94-1569025 NONE | Direct payment from the plan Service code 50 | — | $10K |
| RUSSELL G. WOODSON, D.D.S. EIN 52-7115027 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $8K |
| SERVICE PRINTING CO NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 11960 OAK CREEK PARKWAY HUNTLEY, IL 60142 | $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 | 1,420 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 150 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,570 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,523 | $15.8M |
| Dental(4 contracts, 3 carriers) | NEWPORT DENTAL PLAN | 173 | $135K |
| Vision | VISION SERVICE PLAN | 1,098 | $22K |
| Life insurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 2,335 | $889K |
| Short-term disability | THE UNION LABOR LIFE INSURANCE COMPANY | 2,335 | $88K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 162 | $3.8M |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 2,335 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,335 | — |
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.