| Provider | Services | Address | Compensation |
|---|---|---|---|
| HS&BA EIN 94-3089465 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $120K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $90K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $55K |
| CARROLL & SCULLY, INC. EIN 94-2690827 NONE | Legal; Direct payment from the plan Service code 29 | — | $30K |
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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 146 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 362 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITED HEALTHCARE INSURANCE COMPANY | 43 | $1.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 269 | $193K |
| Vision | VISION SERVICE PLAN | 223 | $38K |
| Life insurance | PRUDENTIAL GROUP INSURANCE | 0 | $0 |
| Other | PRUDENTIAL GROUP INSURANCE | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.