| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 W 34TH ST NEW YORK, NY 10001 | UNION LABOR LIFE INSURANCE CO. | $4K | — | $4K | 1.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSOCIATED THIRD PARTY ADMIN. EIN 94-3187938 NONE | Contract Administrator Service code 13 | — | $4.3M |
| ANTHEM BLUE CROSS EIN 95-3760980 NONE | Plan Administrator Service code 14 | — | $1.7M |
| REGENCE BLUECROSS BLUESHIELD OF UT EIN 87-0200138 CLAIMS PROC SVP | Claims processing; Float revenue Service code 12 | — | $498K |
| THE SEGAL COMPANY, INC. EIN 94-1503999 NONE | Consulting (general) Service code 16 | — | $426K |
| CHARTWELL INVESTMENT PARTNERS EIN 23-2791243 NONE | Investment management Service code 28 | — | $316K |
| HEALTH DYNAMICS, LLC EIN 39-1923786 NONE | Plan Administrator Service code 14 | — | $188K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Float revenue; Claims processing; Other fees Service code 12 | — | $174K |
| MCMORGAN & COMPANY LLC EIN 52-2334338 NONE | Investment management Service code 28 | — | $174K |
| ASSISTANCE RECOVERY PROGRAM EIN 94-3042622 NONE | Other services Service code 49 | — | $173K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing Service code 12 | — | $143K |
| SALTZMAN & JOHNSON EIN 95-2376174 NONE | Legal Service code 29 | — | $142K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | — | $136K |
| INCOME RESEARCH AND MANAGEMENT EIN 04-2955404 NONE | Investment management Service code 28 | — | $95K |
| ENGINEERS PUBLISHING NONE | Other services Service code 49 | 3920 LENNANE DR SACRAMENTO, CA 95834 | $54K |
| MAILRITE PRINT NONE | Copying and duplicating Service code 36 | 834 STRIKER AVE SACRAMENTO, CA 95834 | $43K |
| INTELLI-SERVICES, INC. NONE | Other services Service code 49 | 2440 CAMINO RAMON SAN RAMON, CA 94583 | $36K |
| INVESTMENT PERFORMANCE SERVICES,LLC EIN 58-1645862 NONE | Investment advisory (plan) Service code 27 | — | $35K |
| DENVER MANAGEMENT ADVISORS, INC EIN 55-0888767 NONE | Consulting (general) Service code 16 | — | $30K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Custodial (securities) Service code 19 | — | $26K |
| AMERICAN HEALTH HOLDING, INC. NONE | Consulting (general) Service code 16 | 7400 W CAMPUS RD F-510 NEW ALBANY, OH 43054 | $7K |
| HEMMING MORSE LLP EIN 30-0702322 NONE | Accounting (including auditing) Service code 10 | — | $7K |
| PHARMACY BENEFIT SOLUTIONS EIN 47-0866096 NONE | Consulting (general) Service code 16 | — | $6K |
| BOEHM AND ASSOCIATES EIN 94-2361175 NONE | Other fees Service code 99 | — | $0 |
| STEPHEN HORN INSURANCE SERVICES EIN 94-3249244 NONE | Insurance services Service code 23 | — | $0 |
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 | 15,060 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 15,060 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 9,224 | $39.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 32,988 | $15.8M |
| Life insurance(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 38,663 | $638K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 1,673 | $89K |
| Stop-loss / reinsurancereinsurance(3 contracts, 2 carriers) | UNION LABOR LIFE INSURANCE CO. | 8,481 | $6.9M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 38,663 | $295K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 38,663 | — |
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.