| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED ADMINISTRATIVE SERVICES EIN 94-1749354 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 6800 SANTA TERESA BLVD, SUITE 100 SAN JOSE, CA 95119 | $354K |
| BLUE CROSS EIN 95-3760980 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $134K |
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing Service code 12 | — | $130K |
| KAUFMANN & GOBLE EIN 94-2614826 NONE | Direct payment from the plan; Actuarial Service code 11 | 160 WEST SANTA CLARA ST SUITE 1550 SAN JOSE, CA 95113 | $110K |
| U.A. LOCAL 467 EIN 94-0775047 SPONSOR | Direct payment from the plan; Plan Administrator Service code 14 | 1519 ROLLINS ROAD BURLINGAME, CA 94010 | $77K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $48K |
| NAVIA BENEFIT SOLUTIONS NONE | Direct payment from the plan; Claims processing Service code 12 | PO BOX 3961 SEATTLE, WA 98124 | $42K |
| RXEDO INC. EIN 73-1688722 NONE | Direct payment from the plan; Claims processing Service code 12 | 7800 DALLAS PARKWAY, SUITE 460 PLANO, TX 75024 | $36K |
| NEW CENTURY EIN 68-0189192 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 2838 UNION STREET SAN FRANCISCO, CA 94123 | $31K |
| CRYSTAL CLEAR RX EIN 27-3009945 NONE | Direct payment from the plan; Claims processing Service code 12 | 19753 EAST PIKES PEAK AVENUE G103 PARKER, CO 80138 | $29K |
| NEYHART,ANDERSON,FLYNN & GROSBALL EIN 94-2576729 NONE | Legal; Direct payment from the plan Service code 29 | 369 PINE STREET, SUITE 800 SAN FRANCISCO, CA 94104 | $26K |
| NAVITUS NONE | Direct payment from the plan; Claims processing Service code 12 | 361 INTEGRITY DRIVE MADISON, WI 53717 | $19K |
| JAA ADMINISTRATION NONE | Direct payment from the plan; Claims processing Service code 12 | — | $17K |
| MATRIX TRUST COMPANY EIN 75-3182674 NONE | Custodial (securities); Direct payment from the plan Service code 19 | 717 17TH STREET, SUITE 1300 DENVER, CO 80202 | $12K |
| AMERICAN HEALTH NONE | Direct payment from the plan; Other services Service code 49 | 7400 WEST CAMPUS ROAD, F-510 NEW ALBANY, OH 43054 | $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 | 892 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 273 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 2 | $5K |
| Vision | VISION SERVICE PLAN | 1,191 | $202K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC - STOP LOSS GROUP | 408 | $220K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,649 | — |
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.