| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MENTAL HEALTH ADVISORY GROUP LLC3 | P.O. BOX 399 ALAMEDA, CA 94501 | MANAGED HEALTH NETWORK | $3K | — | $3K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH SERVICES & BENEFITS ADMINIST EIN 94-3089465 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.2M |
| LINDQUIST LLP EIN 52-2385296 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $280K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $249K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $157K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $155K |
| CHARLES BESOCKE NONE | Plan Administrator; Direct payment from the plan Service code 14 | 4160 DUBLIN BLVD., STE. 400 DUBLIN, CA 94568 | $149K |
| SALTZMAN & JOHNSON EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $73K |
| FREMONT BANK EIN 94-1569025 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $36K |
| MCMORGAN AND COMPANY EIN 52-2334338 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $33K |
| GRAYSTONE CONSULTING/MORGAN STANLEY EIN 36-3145972 NONE | Named fiduciary; Direct payment from the plan; Investment advisory (plan); Securities brokerage Service code 27 | — | $27K |
| WEX HEALTH, INC. EIN 06-1593514 NONE | Other services; Direct payment from the plan Service code 49 | — | $25K |
| MACKAY SHIELDS LLC EIN 13-5582869 NONE | Investment management fees paid indirectly by plan Service code 52 | — | $16K |
| AABCO PRINTING EIN 94-1553665 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $14K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $13K |
| SANTA MARIA COMPANY & INSURANCE SER EIN 94-3383631 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $11K |
| SUBURBAN PRESS EIN 94-2477030 NONE | Copying and duplicating; Other services; Direct payment from the plan Service code 36 | — | $10K |
| FARRELL FRITZ, P.C. EIN 06-1620161 NONE | Legal; Direct payment from the plan Service code 29 | — | $10K |
| RYAN THIBODEAU TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | 4160 DUBLIN BLVD., SUITE 400 DUBLIN, CA 94568 | $9K |
| JM RESOURCE CO NONE | Direct payment from the plan; Other services Service code 49 | P.O. BOX 955 SAN RAMON, CA 94583 | $8K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Investment management fees paid directly by plan; Direct payment from the plan; Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $6K |
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 | 3,361 | 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) | 3,361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 4,209 | $32.1M |
| Dental(5 contracts, 5 carriers) | DELTA DENTAL OF CALIFORNIA | 824 | $836K |
| Vision | VISION SERVICE PLAN | 2,834 | $610K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 5,329 | $1.6M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 5,329 | $1.6M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 5,329 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,329 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.