| Provider | Services | Address | Compensation |
|---|---|---|---|
| UFCW GROUP ADMINISTRATION LLC EIN 26-0048379 SALARIED ADMINSTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $7.3M |
| MEDEXPERT INTERNATIONAL INC EIN 94-3360248 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $718K |
| ENVISION RX EIN 90-1011712 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $555K |
| HORIZON ACTUARIAL SERVICES, LLC EIN 38-3647875 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $351K |
| BLUE SHIELD OF CALIFORNIA EIN 94-0360524 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $323K |
| SEGAL COMPANY EIN 94-1503999 NONE | Direct payment from the plan; Actuarial Service code 11 | 100 MONTGOMERY STREET, SUITE 500 SAN FRANCISCO, CA 94104 | $265K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $205K |
| UFCW LOCAL 5 EIN 20-8028546 SPONSOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $188K |
| ACTIVE RADAR EIN 81-0843133 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $178K |
| VISION SERVICE PLAN EIN 23-7316300 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $146K |
| UFCW LOCAL 8 EIN 94-0801845 SPONSOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $137K |
| DELTA DENTAL EIN 94-1461312 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $129K |
| PHARMACY BENEFIT SOLUTIONS EIN 47-0866096 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $110K |
| COBAPAYER EXPRESS NONE | Direct payment from the plan; Other fees Service code 50 | 7500 SECURITY BOULEVARD BALTIMORE, MD 212441850 | $105K |
| NOVACK MACEY LLP NONE | Legal; Direct payment from the plan Service code 29 | 100 N RIVERSIDE PLAZA CHICAGO, IL 60606 | $77K |
| BENEFIT & RISK MANAGEMENT SERVICES EIN 68-0306908 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $65K |
| SEYFARTH & SHAW EIN 36-2152202 NONE | Legal; Direct payment from the plan Service code 29 | — | $59K |
| HGK ASSET MANAGEMENT EIN 52-1296988 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $55K |
| UFCW LOCAL 648 EIN 94-0525380 SPONSOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $33K |
| PART D ADVISORS, INC. EIN 20-2595200 NONE | Other services; Direct payment from the plan Service code 49 | — | $25K |
| NEW ENGLAND PENSION CONSULTANTS EIN 26-1429809 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $17K |
| GREENFIELD LLP NONE | Legal; Direct payment from the plan Service code 29 | 55 S MARKET SAN JOSE, CA 95113 | $16K |
| CIGNA DENTAL EIN 59-1031071 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $8K |
| PODIATRY PLAN EIN 94-2864053 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $7K |
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 | 13,853 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,853 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HEALTH NET | 445 | $2.3M |
| Life insurance | PRUDENTIAL | 592 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,304 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.