| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 | 940 ADAMS STREET, SUITE G BENICIA, CA 94510 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $56K | — | $56K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED ADMINISTRATIVE SERVICES EIN 94-1749354 NONE | Contract Administrator Service code 13 | 6800 SANTA TERESA BLVD, SUITE 100 SAN JOSE, CA 95119 | $362K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 NONE | Contract Administrator; Claims processing; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $205K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial Service code 11 | 2800 CAMPUS DR. SAN MATEO, CA 94403 | $70K |
| LINDQUIST, LLP EIN 52-2385296 NONE | Accounting (including auditing) Service code 10 | 5000 EXECUTIVE PARKWAY, SUITE 400 SAN RAMON, CA 94583 | $62K |
| ASCENDANT HEALTHCARE NONE | Actuarial Service code 11 | 3200 EL CAMINO REAL # 120 IRVINE, CA 92602 | $60K |
| GARCIA HAMILTON & ASSOCIATES NONE | Investment management Service code 28 | 5 HOUSTON CENTER 1401 MCKINNEY, SUITE 1600 HOUSTON, TX 77010 | $49K |
| PILLAR PACIFIC CAPITAL MANAGEMENT NONE | Investment management Service code 28 | 333 GELLERT BLVD, SUITE 121 DALY CITY, CA 94015 | $30K |
| CHARLES SCULLY EIN 94-2690827 NONE | Legal Service code 29 | 300 MONTGOMERY STREET, SUITE 735 SAN FRANCISCO, CA 94104 | $25K |
| INEICH & COMPANY, LLP EIN 56-2552172 NONE | Accounting (including auditing) Service code 10 | 950 TOWER LANE, SUITE 780 FOSTER CITY, CA 94404 | $20K |
| SMART SOURCE CRITICAL COMMUNICATION NONE | Copying and duplicating Service code 36 | P.O. BOX 1726 TUALATIN, OR 97062 | $19K |
| PENSION EVALUATION, INC. EIN 11-2503980 NONE | Investment advisory (plan) Service code 27 | 2450 MIDDLE COUNTRY RD, SUITE 103 CENTEREACH, NY 11720 | $9K |
| US BANK, N.A. EIN 31-0841368 NONE | Custodial (securities) Service code 19 | 221 SOUTH FIGUEROA ST, SUITE 210 LOS ANGELES, CA 90012 | $8K |
| HEALTHSMART NONE | Consulting (general) Service code 16 | 222 WEST LAS COLINAS BOULEVARD SUITE 500N IRVING, TX 75039 | $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 | 1,925 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,925 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF CALIFORNIA | 2,419 | $15.4M |
| Vision | VISION SERVICE PLAN | 1,925 | $182K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,945 | $63K |
| Other | FIDELITY SECURITY LIFE INSURANCE COMPANY | 932 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,419 | — |
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.
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.