| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION SERVICE PLAN3 | 3333 QUALITY DR RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED FARMWORKER OF AMERICA EIN 94-1448579 PLAN SPONSOR | Other commissions Service code 55 | PO BOX 62 KEENE, CA 93531 | $158K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 MEDICAL BENEFITS ACTUARY | Actuarial Service code 11 | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | $138K |
| ROSS COMMUNICATIONS EIN 68-0477696 CONSULTANT | Consulting (general) Service code 16 | 1700 L ST SACRAMENTO, CA 95811 | $120K |
| MENDEZ PETTY MORENO LLP EIN 26-1356482 AUDITOR | Accounting (including auditing) Service code 10 | 900 TRUXTUN AVE SUITE 130 BAKERSFIELD, CA 93301 | $90K |
| PATRICK J PINE EIN 94-6186170 EMPLOYEE | Plan Administrator Service code 14 | — | $85K |
| BUSH GOTTLIEB EIN 95-2956616 ATTORNEY | Legal Service code 29 | 500 N CENTRAL AVE SUITE 800 GLENDALE, CA 91203 | $77K |
| MERCEDES MARTINEZ EIN 94-6186170 EMPLOYEE | Employee (plan) Service code 30 | — | $73K |
| WALTER S NEWMANJR MD EIN 94-2623572 MEDICAL DIRECTOR | Consulting (general) Service code 16 | 6950 SANTA TERESA BLVD SAN JOSE, CA 95119 | $55K |
| NATIONAL CHAVEZ CENTER PLAN PARTICIPANT | Other services Service code 49 | — | $54K |
| GUDALUPE RODRIGUEZ EIN 94-6186170 EMPLOYEE | Employee (plan) Service code 30 | — | $44K |
| KAREN NAVARRO EIN 94-6186170 EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| JACQUELIN GALAVIZ EIN 94-6186170 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 62 KEENE, CA 93531 | $34K |
| ROSA TIRADO EIN 94-6186170 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| VERUS EIN 91-1320111 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | 999 THIRD AVE SUITE 4200 SEATLE, WA 98104 | $31K |
| RACHELLE PEREZ EIN 94-6186170 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| MARIELA GALAVIZ EIN 94-6186170 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 62 KENNE, CA 93531 | $23K |
| MARTINEZ AGUILASOCHO & LYNCH EIN 47-3200127 ATTORNEY | Legal Service code 29 | PO BOX 11208 BAKERSFIELD, CA 933891208 | $15K |
| CESAR CHAVEZ FOUNDATION EIN 95-2466747 PLAN PARTICIPANT | Consulting (general) Service code 16 | — | $10K |
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 | 3,016 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,016 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND INSURANCE | 682 | $1.1M |
| Dental | UNITED HEALTHCARE | 2,896 | $1.2M |
| Vision | VISION SERVICE PLAN | 2,673 | $196K |
| Prescription drug | EXPRESS SCRIPTS | 3,126 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,126 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.