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| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAV-RX EIN 86-1323040 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $673K |
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $177K |
| ANTHEM BLUE CROSS LIFE & HEALTH EIN 95-4331852 NONE | Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $117K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $65K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $54K |
| ABILITY TECHNOLOGY EIN 20-2508922 NONE | Direct payment from the plan; Other services Service code 49 | — | $27K |
| NEYHART, ANDERSON, FLYNN & GROSBOLL EIN 94-2576729 NONE | Legal; Direct payment from the plan Service code 29 | — | $20K |
| NURSE CANDACE CONSULTING NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $15K |
| MAMMINI COMPANY, INC EIN 47-0879697 NONE | Consulting (general); Investment management; Investment advisory (plan); Direct payment from the plan Service code 16 | — | $11K |
| SMART SOURCE EIN 30-0830429 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $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 | 274 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 112 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BC HEALTH INSURANCE COMPANY | 148 | $296K |
| Dental | DELTA DENTAL OF CA | 384 | $0 |
| Vision | VISION SERVICE PLAN | 383 | $39K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 386 | $832K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.