| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC. | 940 ADAMS STREET, SUITE G BENECIA, CA 94510 | UNION LABOR LIFE INSURANCE COMPANY | $30K | — | $30K | 10.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 95-3760980 UNAFFILIATED | Claims processing; Contract Administrator Service code 12 | 21555 OXNARD STREET WOODLAND HILLS, CA 91367 | $6.8M |
| OPTUMRX, INC EIN 33-0441200 UNAFFILIATED | Contract Administrator; Claims processing Service code 12 | PO BOX 9472 MINNEAPOLIS, MN 55440 | $4.8M |
| ASSOCIATED THIRD PARTY ADMIN. EIN 94-2316235 UNAFFILIATED | Claims processing; Plan Administrator Service code 12 | 1182 MARKET STREET, SUITE 320 SAN FRANCISCO, CA 94102 | $968K |
| REUBEN E PRICE & CO. (PAYROLL EXAM) EIN 94-3089756 UNAFFILIATED | Accounting (including auditing) Service code 10 | 3011 CITRUS CIRCLE, SUITE 207 WALNUT CREEK, CA 94598 | $124K |
| TEAMSTERS LOCAL 856 EIN 94-1211646 UNION ASSOC.W/PLAN | Contract Administrator Service code 13 | 453 SAN MATEO AVENUE SAN BRUNO, CA 94066 | $119K |
| RAEL & LETSON EIN 94-1701048 UNAFFILIATED | Consulting (pension); Actuarial Service code 11 | 378 VINTAGE PARK DRIVE FOSTER CITY, CA 94404 | $90K |
| NEW ENGLAND PENSION CONSULTANTS EIN 26-1428909 UNAFFILIATED | Investment advisory (plan) Service code 27 | ONE MAIN STREET, 8TH FLOOR CAMBRIDGE, MA 02142 | $75K |
| REUBEN E. PRICE & CO. CPAS (AUDIT) EIN 94-3089756 UNAFFILIATED | Accounting (including auditing) Service code 10 | 3011 CITRUS CIRCLE, SUITE 207 WALNUT CREEK, CA 94598 | $66K |
| CHARLES SCULLY, JR. EIN 94-2690827 UNAFFILIATED | Legal Service code 29 | 300 MONTGOMERY STREET, SUITE 735 SAN FRANCISCO, CA 94104 | $52K |
| ASCENDANT HEALTHCARE EIN 26-3768186 UNAFFILIATED | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1755 INDIAN WOOD CIRCLE, SUITE 100 MAUMEE, OK 43537 | $36K |
| MARSH USA EIN 36-1436000 UNAFFILIATED | Insurance agents and brokers Service code 22 | PO BOX 85638 SAN DIEGO, CA 92186 | $26K |
| FIRST DENTAL HEALTH EIN 33-0655193 UNAFFILIATED | Claims processing; Contract Administrator Service code 12 | 5771 COPLEY DRIVE SAN DIEGO, CA 92111 | $24K |
| AABCO WESTERN PRESS EIN 94-1553665 UNAFFILIATED | Copying and duplicating Service code 36 | 1300 GALAXY WAY, 20 CONCORD, CA 94520 | $18K |
| JOSEPH LANTHIER (PH)707-933-8377 TRUSTEE | Trustee (individual) Service code 20 | 106 LA MANCHA SONOMA, CA 95476 | $18K |
| JULIE WALL (PH)650-580-7021 TRUSTEE | Trustee (individual) Service code 20 | 7660 BODEGA AVE SEBASTOPOL, CA 95472 | $18K |
| WILLIAM BACIGALUPI (PH)925-686-9210 TRUSTEE | Trustee (individual) Service code 20 | 917 SAVANNA CT. WALNUT CREEK, CA 94598 | $14K |
| IRON MOUNTAIN STORAGE EIN 04-3038590 UNAFFILIATED | Recordkeeping fees Service code 64 | 745 ATLANTIC AVE. BOSTON, MA 02111 | $13K |
| FREMONT BANK EIN 94-1569025 UNAFFILIATED | Account maintenance fees Service code 65 | 25151 CLAWITER RD. HAYWARD, CA 94545 | $9K |
| EMDEON - CHANGE HEALTHCARE, LLC EIN 20-5731067 UNAFFILIATED | Other services Service code 49 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $7K |
| SUBURBAN PRESS EIN 94-2477030 UNAFFILIATED | Copying and duplicating Service code 36 | 22426 THUNDERBIRD PLACE HAYWARD, CA 94545 | $6K |
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 | 2,240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 922 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER PERMANENTE | 1,566 | $31.6M |
| Dental(2 contracts, 2 carriers) | DELTA CARE PMI | 383 | $292K |
| Vision | VISION SERVICE PLAN | 1,755 | $273K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,395 | $26K |
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 410 | $290K |
| Other(4 contracts, 4 carriers) | KAISER PERMANENTE | 2,964 | $31.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,964 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.