| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL PEAK LLC3 | 1390 N MCDOWELL BLVD SUITE G-283 PETALUMA, CA 94954 | SUN LIFE ASSURANCE COMPANY OF CANADA | $538K | — | $538K | 19.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED ADMINISTRATIVE SERVICES EIN 94-1749354 NONE | Contract Administrator Service code 13 | — | $517K |
| ANTHEM BC LIFE AND HEALTH INS CO. EIN 95-4331852 NONE | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $380K |
| SIERRA INVESTMENT PARTNERS, INC. EIN 68-0370668 NONE | Investment management Service code 28 | — | $88K |
| NAVIA BENEFIT SOLUTIONS EIN 91-1467758 NONE | Claims processing Service code 12 | — | $70K |
| PATRIOT GROWTH INSURANCE SERVICES EIN 87-2917800 NONE | Consulting (pension) Service code 17 | — | $65K |
| HEALTHLINX, LLC EIN 87-0660214 NONE | Consulting (general) Service code 16 | — | $50K |
| INEICH & COMPANY, LLP EIN 56-2552172 NONE | Accounting (including auditing) Service code 10 | — | $47K |
| COMPLIANCE AUDIT SERVICES EIN 94-3134229 NONE | Accounting (including auditing) Service code 10 | — | $32K |
| US BANK EIN 31-0841368 NONE | Custodial (securities) Service code 19 | — | $24K |
| NEYHART, ANDERSON, FLYNN & GROSBOLL EIN 94-2576729 NONE | Legal Service code 29 | — | $20K |
| MORGAN STANLEY EIN 94-1671384 NONE | Direct payment from the plan; Investment advisory (plan); Other investment fees and expenses Service code 27 | — | $5K |
| FORT WASHINGTON INVESTMENT ADVISORS EIN 31-1301863 NONE | Investment management fees paid indirectly by plan Service code 52 | — | $0 |
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 | 974 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 365 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLANS INC. | 796 | $7.7M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 2,604 | $1.9M |
| Vision | VISION SERVICE PLAN | 938 | $134K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,041 | $224K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 759 | $2.7M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,041 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,604 | — |
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.