| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOP LOSS INSURANCE SERVICES, INC.3 | 940 ADAMS STREET, SUITE G BENECIA, CA 94510 | UNION LABOR LIFE INSURANCE COMPANY | $38K | — | $38K | 12.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 95-3760980 UNAFFILIATED | Claims processing; Other services Service code 12 | 11030 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | $6.4M |
| OPTUMRX, INC EIN 33-0441200 UNAFFILIATED | Claims processing; Direct payment from the plan; Float revenue; Other fees Service code 12 | PO BOX 9472 MINNEAPOLIS, MN 55440 | $3.6M |
| NORTHWEST ADMINISTRATORS, INC. EIN 91-0680697 UNAFFILIATED | Plan Administrator; Claims processing Service code 12 | 2323 EASTLAKE AVE E. SEATTLE, WA 98102 | $943K |
| TEAMSTERS LOCAL 856 EIN 94-1211646 UNION ASSOC.W/PLAN | Contract Administrator Service code 13 | 453 SAN MATEO AVENUE SAN BRUNO, CA 94066 | $118K |
| 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 | $98K |
| RAEL & LETSON EIN 94-1701048 UNAFFILIATED | Actuarial; Consulting (general) Service code 11 | 378 VINTAGE PARK DRIVE FOSTER CITY, CA 94404 | $91K |
| ASSOCIATED THIRD PARTY ADMIN. EIN 94-2316235 UNAFFILIATED | Claims processing; Plan Administrator Service code 12 | 1182 MARKET STREET, SUITE 320 SAN FRANCISCO, CA 94102 | $85K |
| NEW ENGLAND PENSION CONSULTANTS EIN 26-1428909 UNAFFILIATED | Investment advisory (plan) Service code 27 | ONE MAIN STREET, 8TH FLOOR CAMBRIDGE, MA 02142 | $77K |
| REUBEN E. PRICE & CO.(AUDIT/COMPL.) EIN 94-3089756 UNAFFILIATED | Accounting (including auditing) Service code 10 | 3011 CITRUS CIRCLE, SUITE 207 WALNUT CREEK, CA 94598 | $63K |
| CHARLES SCULLY, JR. EIN 94-2690827 UNAFFILIATED | Legal Service code 29 | 300 MONTGOMERY STREET, SUITE 735 SAN FRANCISCO, CA 94104 | $54K |
| ASCENDANT HEALTHCARE EIN 26-3768186 UNAFFILIATED | Other services Service code 49 | 1755 INDIAN WOOD CIRCLE, SUITE 100 MAUMEE, OK 43537 | $53K |
| MARSH USA EIN 36-1436000 UNAFFILIATED | Insurance agents and brokers; Insurance services Service code 22 | 9171 TOWNE CENTRE DR. SAN DIEGO, CA 92122 | $27K |
| FREMONT BANK EIN 94-1569025 UNAFFILIATED | Other services Service code 49 | 25151 CLAWITER RD. HAYWARD, CA 94545 | $27K |
| FIRST DENTAL HEALTH EIN 33-0655193 UNAFFILIATED | Other services Service code 49 | PO BOX 919029 SAN DIEGO, CA 92191 | $24K |
| JULIE WALL (PH)650-580-7021 TRUSTEE | Trustee (individual) Service code 20 | 7660 BODEGA AVE SEBASTOPOL, CA 95472 | $19K |
| JOSEPH LANTHIER (PH)707-933-8377 TRUSTEE | Trustee (individual) Service code 20 | 106 LA MANCHA SONOMA, CA 95476 | $17K |
| THE VIRTUOUS GROUP EIN 27-0365275 UNAFFILIATED | Consulting fees Service code 70 | 1930 VILLAGE CENTER CIRCLE, 3-397 LAS VEGAS, NV 89134 | $12K |
| IRON MOUNTAIN STORAGE EIN 04-3038590 UNAFFILIATED | Recordkeeping fees Service code 64 | 745 ATLANTIC AVE. BOSTON, MA 02111 | $11K |
| ULLICO INVESTMENT EIN 13-1423090 UNAFFILIATED | Investment management fees paid indirectly by plan Service code 52 | 8403 COLESVILLE RD SILVER SPRING, MO 20910 | $9K |
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 | 3,106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 920 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,026 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER PERMANENTE | 2,532 | $37.1M |
| Dental(2 contracts, 2 carriers) | DELTA CARE PMI | 396 | $305K |
| Vision | VISION SERVICE PLAN | 1,581 | $256K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,312 | $25K |
| Prescription drug | UNITED AMERICAN INSURANCE COMPANY | 469 | $322K |
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 367 | $313K |
| Other(5 contracts, 5 carriers) | KAISER PERMANENTE | 4,008 | $26.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,008 | — |
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.