| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED ADMINISTRATIVE SERVICES EIN 94-1749354 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $525K |
| BLUE CROSS EIN 95-3760980 NONE | Plan Administrator; Direct payment from the plan Service code 14 | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | $349K |
| NAVIA BENEFIT SOLUTIONS NONE | Claims processing; Direct payment from the plan Service code 12 | PO BOX 3961 SEATTLE, WA 98124 | $110K |
| J HERRLE EIN 93-0692196 NONE | Insurance agents and brokers; Consulting (general); Direct payment from the plan Service code 16 | 1800 SW FIRST AVENUE, SUITE 280 PORTLAND, OR 97201 | $64K |
| HEMMING MORSE EIN 30-0702322 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $58K |
| FIRST DENTAL HEALTH EIN 33-0655193 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $48K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $46K |
| CONCENTRA PREFERRED SYSTEMS EIN 36-3715258 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $45K |
| 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 | $41K |
| KRAW LAW GROUP EIN 77-0171216 NONE | Legal; Direct payment from the plan Service code 29 | 605 ELLIS STREET MOUNTAIN VIEW, CA 94043 | $38K |
| KAUFMANN & GOBLE EIN 94-2614826 NONE | Actuarial; Direct payment from the plan Service code 11 | 160 W SANTA CLARA STREET SAN JOSE, CA 95113 | $32K |
| MARCO CONSULTING GROUP, INC. NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | 550 W WASHINGTON BLVD 900 CHICAGO, IL 60661 | $25K |
| ALLIANCE BERNSTEIN NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 555 CALIFORNIA ST, SAN FRANCISCO, CA 94104 | $19K |
| LOOMIS SAYLES NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 555 CALIFORNIA ST., SUITE 3300 SAN FRANCISCO, CA 94104 | $17K |
| IBEW LOCAL 332 EIN 94-0577280 PARTY IN INTEREST | Direct payment from the plan; Plan Administrator Service code 14 | — | $11K |
| S CAMPBELL EIN 77-0102183 NONE | Other fees; Direct payment from the plan Service code 50 | 1155 NORTH FIRST STREET, SUITE 101 SAN JOSE, CA 95112 | $10K |
| MATRIX FINANCIAL SOLUTIONS EIN 20-1591048 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 717 17TH ST SUITE 1300 DENVER, CO 80202 | $9K |
| RESTAT NONE | Other fees; Direct payment from the plan Service code 50 | 11900 W. LAKE PARK DRIVE MILWAUKEE, WI 53224 | $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 | 2,155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 933 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,088 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 277 | $1.2M |
| Life insurance | PRINCIPAL FINANCIAL GROUP | 2,155 | $213K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,051 | $1.3M |
| Other | HARTFORD LIFE AND ACCIDENT | 153 | $435K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,041 | — |
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.