| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC. | 940 ADAMS STREET, SUITE G BENECIA, CA 94510 | FIDELITY LIFE INSURANCE COMPANY | $76K | — | $76K | 9.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CCC ELECTRICAL IND LABOR MGMT CO TR EIN 68-0299780 BENEFIT ADMINISTRATOR | Plan Administrator; Accounting (including auditing); Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 10 | 1024 COURT STREET MARTINEZ, CA 945534239 | $201K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 SERVICE PROVIDER | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $128K |
| RAEL & LETSON EIN 94-1701048 CONSULTANT | Consulting (general) Service code 16 | 2800 CAMPUS DRIVE, SUITE 150 SAN MATEO, CA 94403 | $59K |
| SAVRX PRESCRIPTION SERVICES EIN 47-0527013 PRESCRIPTION SERVICE | Other services Service code 49 | 224 N. PARK AVENUE FREMONT, NE 68025 | $52K |
| NEYHART, ANDERSON, FLYNN & GROSBOLL EIN 94-2576729 ATTORNEY | Legal Service code 29 | 44 MONTGOMERY ST., SUITE 2080 SAN FRANCISCO, CA 94104 | $34K |
| BUCKLEY PATCHEN EIN 94-2302150 AUDITOR | Accounting (including auditing) Service code 10 | 2890 NORTH MAIN ST., SUITE 200 WALNUT CREEK, CA 94597 | $31K |
| MILLER, KAPLAN & ARASE & CO., LLP EIN 95-2036255 PAYROLL AUDITOR | Accounting (including auditing) Service code 10 | TWO EMBARCADERO CTR, SUITE 2280 SAN FRANCISCO, CA 94104 | $30K |
| BEAT IT EAP EAP PROVIDER | Consulting (general) Service code 16 | 20079 STONE OAK PARKWAY 1105 SAN ANTONIO, TX 78258 | $17K |
| IBEW LOCAL 302 EIN 94-0577315 LABOR REP. | Other services; Employee (plan) Service code 30 | 1875 ARNOLD DRIVE MARTINEZ, CA 945534239 | $16K |
| DODGE AND COX FUNDS - DODIX FUND CUSTODIAN | Custodial (securities); Investment management; Other investment fees and expenses Service code 19 | PO BOX 8422 BOSTON, MA 022668422 | $16K |
| DODGE AND COX FUNDS - DODGX FUND CUSTODIAN | Custodial (securities); Investment management; Other investment fees and expenses Service code 19 | PO BOX 8422 BOSTON, MA 022668422 | $12K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 INVESTMENT MANAGER | Other fees; Custodial (securities); Other investment fees and expenses; Investment management Service code 19 | ONE LINCOLN STREET BOSTON, MA 02111 | $721 |
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 | 787 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 347 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,685 | $13.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,188 | $1.8M |
| Stop-loss / reinsurancereinsurance | FIDELITY LIFE INSURANCE COMPANY | 491 | $802K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,685 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.