| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Contract Administrator; Direct payment from the plan Service code 13 | 1731 TECHNOLOGY DRIVE SAN JOSE, CA 95110 | $603K |
| DELTA DENTAL EIN 94-1461312 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $307K |
| BLUE CROSS EIN 95-3760980 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $161K |
| NWQ INVESTMENTS EIN 47-0875103 NONE | Direct payment from the plan; Investment management Service code 28 | 2049 CENTURY PARK EAST 16TH FLOOR LOS ANGELES, CA 94105 | $105K |
| KAUFMANN & GOBLE EIN 94-2614826 NONE | Direct payment from the plan; Actuarial Service code 11 | 160 WEST SANTA CLARA STREET SAN JOSE, CA 95113 | $102K |
| HEMMING MORSE EIN 30-0702322 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $101K |
| NANCY FERGUSON EIN 94-6401544 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| KRAW LAW GROUP EIN 77-0171216 NONE | Legal; Direct payment from the plan Service code 29 | 605 ELLIS STREET STE 200 MOUNTAIN VIEW, CA 94043 | $62K |
| BEAT IT PROGRAM EIN 77-0111619 NONE | Other services; Direct payment from the plan Service code 49 | — | $55K |
| WELLS FARGO ADVISORS EIN 23-2384840 NONE | Direct payment from the plan; Investment management Service code 28 | 550 SOUTH WINCHESTER BLVD., STE 601 SAN JOSE, CA 95128 | $42K |
| MATRIX TRUST EIN 75-3182674 NONE | Custodial (securities); Direct payment from the plan Service code 19 | 2800 NORTH CENTRAL AVE STE 900 PHOENIX, AZ 85004 | $25K |
| EVOLUTION BENEFITS EIN 06-1593514 NONE | Other fees; Claims processing; Direct payment from the plan Service code 12 | 22 WATERVILLE ROAD AVON, CT 06001 | $23K |
| TRUVERIS EIN 27-4345686 NONE | Direct payment from the plan; Other services Service code 49 | — | $12K |
| WYLIE, MCBRIDE, PLATTEN & RENNER EIN 94-2633731 NONE | Legal; Direct payment from the plan Service code 29 | 2125 CONOAS GARDEN AVE STE 120 SAN JOSE, CA 95125 | $11K |
| GREGORY GONZALES EIN 94-6401544 PARTY-IN-INTEREST | Trustee (individual); Direct payment from the plan Service code 20 | — | $9K |
| GARY GLENN EIN 94-6401544 PARTY-IN-INTEREST | Direct payment from the plan; Trustee (individual) Service code 20 | — | $6K |
| COLUMBIA NONE | Investment management; Investment management fees paid directly by plan Service code 28 | PO BOX 8099 BOSTON, MA 02266 | $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 | 1,913 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 556 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,469 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,459 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,210 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.