| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | $27K | — | $27K | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 NONE | Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $2.1M |
| BENESYS, INC. EIN 38-2383171 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $1.1M |
| ELECTRICAL INDUSTRY SERVICE CORP. EIN 94-3053367 RELATED ORGANIZATION | Plan Administrator; Direct payment from the plan Service code 14 | — | $167K |
| BAYSPORT INC NONE | Other services; Direct payment from the plan Service code 49 | 14830 LOS GATOS BLVD STE 101 LOS GATOS, CA 95032 | $157K |
| WEDGE CAPITAL MANAGEMENT EIN 56-1557450 NONE | Investment management fees paid directly by plan Service code 51 | — | $106K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $86K |
| CHARTWELL INVESTMENT PARTNERS, LLC EIN 36-4776242 NONE | Investment management; Named fiduciary; Investment management fees paid directly by plan Service code 28 | — | $63K |
| LIFEWORKS EIN 52-1883918 NONE | Direct payment from the plan; Other services Service code 49 | — | $57K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $53K |
| LEONARD CARDER, LLP EIN 94-2819269 NONE | Legal; Direct payment from the plan Service code 29 | — | $43K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Float revenue; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $37K |
| SMARTSOURCE EIN 30-0830429 NONE | Direct payment from the plan; Other services Service code 49 | — | $26K |
| SAN JOAQUIN & CALAVERAS CTY JATC EIN 94-6411032 NONE | Direct payment from the plan; Other services Service code 49 | — | $22K |
| INVESTMENT PERFORMANCE SERVICES LLC EIN 58-2432390 NONE | Direct payment from the plan; Consulting (general); Investment advisory (plan) Service code 16 | — | $15K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $10K |
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 | 1,393 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 546 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,939 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 3,194 | $35.6M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 4,715 | $3.2M |
| Vision | VISION SERVICE PLAN | 1,496 | $167K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 143 | $388K |
| Other | U.S. BEHAVIORAL HEALTH PLAN OF CALIFORNIA DBA OPTUM | 1,816 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,715 | — |
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.