| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE SERVICES INC | 940 ADAMS STREET, SUITE G BENICIA, CA 94510 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $17K | — | $17K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $147K |
| U.A. LOCAL 355 EIN 68-0189344 PLAN SPONSOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $48K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $32K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $31K |
| KRAW & KRAW LEGAL GROUP EIN 32-0465891 NONE | Legal; Direct payment from the plan Service code 29 | — | $30K |
| LINDQUIST LLP EIN 52-2385296 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $27K |
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $20K |
| CITY NATIONAL BANK EIN 95-1780067 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $12K |
| MCMORGAN & COMPANY LLC EIN 52-2334338 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $11K |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 195 | $22K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 468 | $8K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 143 | $332K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 468 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 468 | — |
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."
No prospect flags tripped on this filing.