No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA FUND ADMINISTRATORS LLC EIN 45-2636626 | Contract Administrator; Direct payment from the plan Service code 13 | 1234 WEST OAK STREET STOCKTON, CA 95203 | $63K |
| SAICHEK LAW FIRM APC EIN 26-0806256 | Legal; Direct payment from the plan Service code 29 | 2445 FIFTH AVENUE SUITE 332 SAN DIEGO, CA 92101 | $34K |
| MOSS ADAMS LLP EIN 91-0189318 | Direct payment from the plan; Accounting (including auditing) Service code 10 | 3100 ZINFANDEL DRIVE 5TH FLOOR RANCHO CORDOVA, CA 95670 | $16K |
| PAYDEN & RYGEL EIN 95-3921788 | Investment advisory (plan); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management Service code 27 | 333 SOUTH GRAND AVE STE 3200 LOS ANGELES, CA 90071 | $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 | 810 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 87 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 498 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,395 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.