| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18700 HAYDEN ROAD, SUITE 405 SCOTTSDALE, AZ 85255 | THE UNION LABOR LIFE INSURANCE COMPANY | $259K | — | $259K | 8.90% |
| STEPHEN CHELBAY COMPANY3 | 6800 SANTA TERESA BLVD., #100 SAN JOSE, CA 95119 | DELTA DENTAL OF CALIFORNIA | $38K | — | $38K | 3.41% |
| STEPHEN CHELBAY COMPANY3 | 6800 SANTA TERESA BLVD, SUITE #100 SAN JOSE, CA 95119 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 2.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED ADMINISTRATIVE SERVICES EIN 94-1749354 NONE | Contract Administrator Service code 13 | 6800 SANTA TERESA BOULEVARD SUITE 100 SAN JOSE, CA 95119 | $558K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 NONE | Claims processing; Contract Administrator; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 3350 PEACHTREE ROAD ATLANTA, GA 30326 | $272K |
| SALTZMAN & JOHNSON EIN 94-2376174 NONE | Legal Service code 29 | 5100-B1 CLAYTON ROAD, SUITE 373 CONCORD, CA 94521 | $71K |
| MCMORGAN & COMPANY LLC EIN 52-2334338 NONE | Investment advisory (plan) Service code 27 | ONE FRONT STREET SUITE 500 SAN FRANCISCO, CA 94111 | $55K |
| MILLIMAN EIN 91-0675641 NONE | Consulting (general) Service code 16 | 2175 N. CALIFORNIA BLVD., SUITE 810 WALNUT CREEK, CA 94596 | $47K |
| BEAT IT! PROGRAM INC EIN 77-0111619 NONE | Other services Service code 49 | 920 SARATOGA AVENUE, SUITE 207 SAN JOSE, CA 95129 | $40K |
| SAV-RX PRESCRIPTION SERVICES EIN 47-0527013 NONE | Claims processing Service code 12 | 224 NORTH PARK AVENUE FREMONT, NE 68025 | $32K |
| MILLER, KAPLAN, ARASE, & CO., LLP EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | 4123 LANKERSHIM BLVD NORTH HOLLYWOOD, CA 91602 | $31K |
| NEYHART, ANDERSON, FLYNN & GROSBOLL EIN 94-2576729 NONE | Legal Service code 29 | 369 PINE STREET SUITE 800 SAN FRANCISCO, CA 941043323 | $23K |
| INEICH & COMPANY, LLP EIN 56-2552172 NONE | Accounting (including auditing) Service code 10 | 950 TOWER LANE SUITE 780 FOSTER CITY, CA 94404 | $22K |
| HINGE HEALTH INC EIN 81-1884841 NONE | Other services Service code 49 | 455 MARKET STREET, SUITE 700 SAN FRANCISCO, CA 94105 | $18K |
| STEPHEN CHELBAY CO. EIN 94-1750014 NONE | Consulting (general) Service code 16 | P.O. BOX 5057 SAN JOSE, CA 95128 | $12K |
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 | 1,862 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 86 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,948 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 2,579 | $14.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,042 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,936 | $134K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,034 | $129K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,156 | $2.9M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,034 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,579 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.