| Provider | Services | Address | Compensation |
|---|---|---|---|
| HS&BA EIN 94-3089465 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $121K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Actuarial; Direct payment from the plan; Consulting (pension) Service code 11 | — | $50K |
| VAVRINEK, TRINE, DAY & CO., LLP EIN 95-2648289 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| CARROLL & SCULLY, INC. EIN 94-2690827 NONE | Legal; Direct payment from the plan Service code 29 | — | $30K |
| ROSEMARIE BOOTHE-BEY EIN 94-6102898 TRUSTEE | Trustee (individual) Service code 20 | — | $6K |
| US BANK EIN 94-6102898 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $5K |
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 | 332 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 167 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 99 | $1.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 797 | $364K |
| Vision | VISION SERVICE PLAN | 331 | $61K |
| Life insurance | PRUDENTIAL | 323 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 823 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.