| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MENTAL HEALTH ADVISORY GROUP LLC3 | PO BOX 399 ALAMEDA, CA 94501 | MANAGED HEALTH NETWORK | $30K | — | $30K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIPMAN INSURANCE ADMINISTRATORS INC EIN 94-3042186 NONE | Contract Administrator; Copying and duplicating; Direct payment from the plan Service code 13 | — | $6.6M |
| ANTHEM BLUE CROSS EIN 95-3760980 NONE | Direct payment from the plan; Claims processing; Other services Service code 12 | — | $1.0M |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $330K |
| BEESON, TAYER AND BODINE EIN 94-3126136 NONE | Legal; Direct payment from the plan Service code 29 | — | $315K |
| TEAMSTERS' ASSISTANCE PROGRAM EIN 68-0048516 NONE | Other services; Direct payment from the plan Service code 49 | — | $258K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $252K |
| PITNEY BOWES NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 3001 SUMMER STREET STAMFORD, CT 06905 | $207K |
| HEALTH MANAGEMENT CONCEPTS EIN 75-3189468 NONE | Direct payment from the plan; Other services Service code 49 | — | $204K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $197K |
| INVESCO ADVISERS, INC. EIN 58-1707262 NONE | Investment management fees paid indirectly by plan; Direct payment from the plan; Investment management Service code 28 | — | $164K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Claims processing; Other fees; Float revenue; Direct payment from the plan Service code 12 | — | $86K |
| ASCENDANT HEALTHCARE INC EIN 26-3768186 NONE | Other services; Direct payment from the plan Service code 49 | — | $64K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $49K |
| JP MORGAN EIN 13-3200244 NONE | Investment management fees paid indirectly by plan; Direct payment from the plan; Investment management; Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $46K |
| U.S. BANK EIN 31-0841368 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $43K |
| ALAN D. BILLER & ASSOCIATES EIN 94-2854958 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $42K |
| AMERICAN HEALTH HOLDING INC EIN 31-1368946 NONE | Direct payment from the plan; Other services Service code 49 | — | $33K |
| IRON MOUNTAIN RECORD MGMT EIN 04-3038590 NONE | Direct payment from the plan; Other services Service code 49 | — | $30K |
| PACIFIC STANDARD PRESS EIN 01-0551382 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $23K |
| ONE RHYTHM EIN 80-0812990 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $16K |
| ALPHA PRESS EIN 94-2855338 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $11K |
| STEPHEN HORN INSURANCE EIN 94-3249244 NONE | Insurance brokerage commissions and fees Service code 53 | — | $10K |
| WHEELER SONOMA EIN 20-8452680 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $10K |
| SAFEGUARD BUSINESS SYSTEM EIN 23-1689322 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $9K |
| UPS NONE | Direct payment from the plan; Other services Service code 49 | 55 GLENLAKE PARKWAY, NE ATLANTA, GA 30328 | $7K |
| BILL ROSSI EIN 94-2848389 TRUSTEE | Trustee (individual); Named fiduciary; Direct payment from the plan Service code 20 | — | $7K |
| CW ASSOCIATES EIN 59-3821770 NONE | Participant communication; Direct payment from the plan Service code 38 | — | $7K |
| ONE NET PPO EIN 52-2129786 NONE | Other services; Direct payment from the plan Service code 49 | — | $7K |
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 | 14,024 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,539 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 18,563 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 19,937 | $155.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 25,820 | $20.7M |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 18,249 | $181K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 720 | $760K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 18,249 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 25,820 | — |
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.