| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MENTAL HEALTH ADVISORY GROUP LLC3 | PO BOX 399 ALAMEDA, CA 94501 | MANAGED HEALTH NETWORK | $32K | — | $32K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIPMAN INSURANCE ADMINISTRATORS INC EIN 94-3042186 NONE | Copying and duplicating; Contract Administrator; Direct payment from the plan Service code 13 | — | $6.9M |
| ANTHEM BLUE CROSS EIN 95-3760980 NONE | Direct payment from the plan; Other services; Claims processing Service code 12 | — | $806K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $387K |
| BEESON, TAYER AND BODINE EIN 94-3126136 NONE | Legal; Direct payment from the plan Service code 29 | — | $364K |
| TEAMSTERS' ASSISTANCE PROGRAM EIN 68-0048516 NONE | Direct payment from the plan; Other services Service code 49 | — | $260K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $258K |
| HEALTH MANAGEMENT CONCEPTS EIN 75-3189468 NONE | Direct payment from the plan; Other services Service code 49 | — | $198K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $197K |
| PITNEY BOWES NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 3001 SUMMER STREET STAMFORD, CT 06905 | $176K |
| ASCENDANT HEALTHCARE INC EIN 26-3768186 NONE | Other services; Direct payment from the plan Service code 49 | — | $132K |
| ARROWSTREET CAPITAL EIN 04-3472863 NONE | Investment management; Direct payment from the plan Service code 28 | — | $127K |
| JP MORGAN EIN 13-3200244 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Direct payment from the plan; Investment advisory (plan); Investment management Service code 27 | — | $116K |
| INVESCO ADVISERS, INC. EIN 58-1707262 NONE | Investment management fees paid indirectly by plan; Investment management; Direct payment from the plan Service code 28 | — | $94K |
| PGIM REAL ESTATE EIN 46-1242033 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $92K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Other fees; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $64K |
| ALAN D. BILLER & ASSOCIATES EIN 94-2854958 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $62K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $51K |
| U.S. BANK EIN 31-0841368 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $45K |
| IRON MOUNTAIN RECORD MGMT EIN 04-3038590 NONE | Direct payment from the plan; Other services Service code 49 | — | $41K |
| PACIFIC STANDARD PRESS EIN 01-0551382 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $24K |
| WHEELER SONOMA EIN 20-8452680 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $21K |
| ONE RHYTHM EIN 80-0812990 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $17K |
| STEPHEN HORN INSURANCE EIN 94-3249244 NONE | Insurance brokerage commissions and fees Service code 53 | — | $17K |
| CW ASSOCIATES EIN 59-3821770 NONE | Participant communication; Direct payment from the plan Service code 38 | — | $9K |
| UPS EIN 36-2407381 NONE | Other services; Direct payment from the plan Service code 49 | — | $8K |
| ALPHA PRESS EIN 94-2855338 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $6K |
| AMERICAN HEALTH HOLDING INC EIN 31-1368946 NONE | Direct payment from the plan; Other services Service code 49 | — | $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 | 13,838 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,633 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 18,471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 19,959 | $157.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 27,993 | $21.8M |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 10,824 | $176K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 352 | $585K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 726 | $840K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 10,824 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 27,993 | — |
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.