| Provider | Services | Address | Compensation |
|---|---|---|---|
| UFCW GROUP ADMINISTRATION LLC EIN 26-0048379 SALARIED ADMINSTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $6.7M |
| MEDEXPERT INTERNATIONAL INC EIN 94-3360248 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $582K |
| ELIXIR EIN 90-1011712 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $515K |
| BLUE SHIELD OF CALIFORNIA EIN 94-0360524 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $400K |
| HORIZON ACTUARIAL SERVICES, LLC NONE | Direct payment from the plan; Actuarial Service code 11 | 1040 CROWN POINTE PARKWAY SUITE 560 ATLANTA, GA 30338 | $257K |
| ACTIVE RADAR EIN 81-0843133 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $188K |
| SEYFARTH & SHAW EIN 36-2152202 NONE | Legal; Direct payment from the plan Service code 29 | — | $162K |
| VISION SERVICE PLAN EIN 23-7316300 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $157K |
| SEGAL COMPANY EIN 94-1503999 NONE | Actuarial; Direct payment from the plan Service code 11 | 100 MONTGOMERY STREET, SUITE 500 SAN FRANCISCO, CA 94104 | $157K |
| UFCW LOCAL 5 EIN 20-8028546 SPONSOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $157K |
| BENEFIT & RISK MANAGEMENT SERVICES NONE | Direct payment from the plan; Consulting (general) Service code 16 | 80 IRON POINT CIRCLE, SUITE 200 FOLSOM, CA 95630 | $127K |
| UFCW LOCAL 8 EIN 94-0801845 SPONSOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $116K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $109K |
| DELTA DENTAL EIN 94-1461312 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $105K |
| COBAPAYER EXPRESS NONE | Other fees; Direct payment from the plan Service code 50 | 7500 SECURITY BOULEVARD BALTIMORE, MD 212441850 | $84K |
| PHARMACY BENEFIT SOLUTIONS EIN 47-0866096 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $75K |
| HGK ASSET MANAGEMENT EIN 52-1296988 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $66K |
| UFCW LOCAL 648 EIN 94-0525380 SPONSOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $28K |
| PART D ADVISORS, INC. NONE | Other services; Direct payment from the plan Service code 49 | 17199 N LAUREL PARK DR., SUITE 400 LIVONIA, MI 48152 | $20K |
| NEW ENGLAND PENSION CONSULTANTS EIN 04-2927339 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $16K |
| OPTUMINSIGHT NONE | Contract Administrator; Direct payment from the plan Service code 13 | 11000 OPTUM CIR EDEN PRAIRE, MN 55344 | $12K |
| PODIATRY PLAN EIN 94-2864053 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $8K |
| CIGNA DENTAL EIN 59-1031071 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $6K |
| MCCRACKEN, STEMERMAN & HOLSBERRY EIN 94-1709555 NONE | Legal; Direct payment from the plan Service code 29 | — | $5K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14,299 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 14,299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HEALTH NET | 500 | $2.6M |
| Life insurance | PRUDENTIAL | 951 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,722 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.