| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLANS INC. | — | — | $0 | 0.00% |
| NONE | — | UNITED HEALTHCARE INSURANCE COMPANY | — | — | $0 | 0.00% |
| STOP LOSS INSURANCE SERVICES, INC.3 Filed as: STOP LOSS INSURANCE GROUP | 940 ADAMS STREET, SUITE G BENICIA, CA 94510 | AIG BENEFIT SOLUTIONS | $15K | $0 | $15K | 5.26% |
| NONE | — | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| NONE | — | THE UNION LABOR LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | UNITEDHEALTHCARE OF CALIFORNIA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ATPA EIN 94-3187938 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $216K |
| RAEL & LETSON EIN 94-1701042 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $88K |
| KRAW LAW GROUP EIN 77-0171216 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $67K |
| BLUE SHIELD EIN 94-2822302 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $62K |
| MCCRAKEN, STEMERMAN, & HOLSBERRY EIN 94-1770955 NONE | Legal; Direct payment from the plan Service code 29 | — | $50K |
| BOYD WATTERSON NONE | Direct payment from the plan Service code 50 | 1801 E 9TH STREET SUITE 1400 CLEVELAND, OH 44114 | $36K |
| HEMMING MORSE LLP EIN 30-0702322 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $24K |
| JACOBS & CO. EIN 94-3056301 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $21K |
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $21K |
| BITTNER & CO. EIN 94-3230561 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| PENN CAPITAL EIN 45-0635462 NONE | Investment management fees paid directly by plan; Direct payment from the plan Service code 50 | — | $15K |
| INVESTMENT PERFORMANCE SERVICES LLC EIN 58-2432390 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $10K |
| RICHARD ROMANSKI EIN 94-6173454 TRUSTEE | Trustee (individual) Service code 20 | — | $9K |
| W.W. WARD III EIN 94-6173454 TRUSTEE | Trustee (individual) Service code 20 | — | $9K |
| COMERICA BANK EIN 38-3243681 NONE | Float revenue; Other fees; Custodial (other than securities); Direct payment from the plan; Shareholder servicing fees Service code 18 | — | $8K |
| HEALTHNOW NONE | Claims processing; Direct payment from the plan Service code 12 | 801 LAKEVIEW DRIVE, SUITE 301 BLUE BELL, PA 14922 | $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 | 681 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 701 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 746 | $109K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 599 | $10K |
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 243 | $279K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 599 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,027 | — |
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.