| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN INC | — | — | $0 | 0.00% |
| NONE | — | HEALTH NET | — | — | $0 | 0.00% |
| NILBEY & HERRLE AGENCIES | 1800 SW 1ST AVE ST 280 PORTLAND, OR 97201 | SYMETRA LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | UNITEDHEALTHCARE OF CALIFORNIA | — | — | $0 | 0.00% |
| NONE | — | HARTFORD LIFE AND ACCIDENT | — | — | $0 | 0.00% |
| NONE | — | PRINCIPAL FINANCIAL GROUP | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED ADMINISTRATIVE SERVICES EIN 94-1749354 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $494K |
| BLUE CROSS EIN 95-3760980 NONE | Plan Administrator; Direct payment from the plan Service code 14 | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | $245K |
| CONCENTRA PREFERRED SYSTEMS EIN 36-3715258 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $77K |
| J HERRLE EIN 93-0692196 NONE | Consulting (general); Insurance agents and brokers; Direct payment from the plan Service code 16 | 1800 SW FIRST AVENUE, SUITE 280 PORTLAND, OR 97201 | $59K |
| KRAW LAW GROUP EIN 77-0171216 NONE | Legal; Direct payment from the plan Service code 29 | 605 ELLIS STREET MOUNTAIN VIEW, CA 94043 | $58K |
| HEMMING MORSE EIN 30-0702322 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $53K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $37K |
| BEAT IT EIN 77-0111619 NONE | Claims processing; Direct payment from the plan Service code 12 | 1798 TECHNOLOGY DRIVE, SUITE 238 SAN JOSE, CA 95110 | $35K |
| KAUFMANN & GOBLE EIN 94-2614826 NONE | Direct payment from the plan; Actuarial Service code 11 | 160 W SANTA CLARA STREET SAN JOSE, CA 95113 | $32K |
| FIRST DENTAL HEALTH EIN 33-0655193 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $28K |
| MCMORGAN & COMPANY EIN 52-2334338 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $24K |
| S CAMPBELL EIN 77-0102183 NONE | Direct payment from the plan; Other fees Service code 50 | 1155 NORTH FIRST STREET, SUITE 101 SAN JOSE, CA 95112 | $20K |
| IBEW LOCAL 332 EIN 94-0577280 PARTY IN INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $15K |
| MARCO CONSULTING GROUP, INC. NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | 550 W WASHINGTON BLVD 900 CHICAGO, IL 60661 | $15K |
| STEVE WHETZEL EIN 94-3212596 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| ALAN BILLER & ASSOC EIN 94-2854958 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | 535 MIDDLEFIELD ROAD, SUITE 230 MENLO PARK, CA 94025 | $13K |
| MATRIX FINANCIAL SOLUTIONS EIN 20-1591048 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 717 17TH ST SUITE 1300 DENVER, CO 80202 | $7K |
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 | 1,788 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 975 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,763 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 317 | $1.2M |
| Life insurance | PRINCIPAL FINANCIAL GROUP | 1,799 | $189K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 969 | $1.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 131 | $413K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,302 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.