| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP - CA3 | 940 ADAMS STREET, SUITE G BENICIA, CA 94510 | THE UNION LABOR LIFE INSURANCE COMPANY | $27K | — | $27K | 9.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $157K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $57K |
| U.A. LOCAL 355 EIN 68-0189344 PLAN SPONSOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $36K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $35K |
| KRAW LAW GROUP, APC EIN 32-0465891 NONE | Legal; Direct payment from the plan Service code 29 | — | $30K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Claims processing; Direct payment from the plan; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Insurance services Service code 12 | — | $24K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $19K |
| DELTA DENTAL EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $15K |
| CITY NATIONAL BANK EIN 95-1780067 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $11K |
| TOPAZ PRINTING EIN 55-2279858 NONE | Direct payment from the plan; Other services Service code 49 | — | $9K |
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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 117 | $16K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 330 | $5K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 81 | $280K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 330 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.