| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $664K | $664K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $570K | $570K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $517K | $517K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $54K | $54K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $53K | $53K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $26K | $26K | 25.00% |
| DOUG BORG3 | 42425 JACKSON ST C104 INDIO, CA 92203 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $226 | — | $226 | 3.93% |
| DEREK SCHELL3 | 23875 VENTURA BLVD SUITE 201B CALABASAS, CA 91302 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.09% |
| JEFFREY REYNOLDS3 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | JACKSON NATIONAL LIFE INSURANCE COMPANY | $42 | — | $42 | 13.42% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | FIDELITY SECURITY LIFE | — | $6 | $6 | 3.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENJAMIN SYBESMA EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $290K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $269K |
| RUIZ GUADALUPE EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $250K |
| DANIEL BEAMAN EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $215K |
| JAMES BAUMILLER EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $209K |
| DEBORAH A JOHNSON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $150K |
| SHANA M POWELL EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $144K |
| PETER J SANDS EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $144K |
| JORDAN BARGAS EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $134K |
| SHALLY SIGNH EIN 94-6459649 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $133K |
| MELISSA GRANDY EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $123K |
| ANGELA MURILLO EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $122K |
| VERONICA M SAMPSON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $121K |
| TRUCKER HUSS EIN 94-3216063 NONE | Legal; Direct payment from the plan Service code 29 | — | $116K |
| MARIETTA TANGUILEG EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| JOTI CHAND EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| LYNN NOLAND EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| KATHRYN A KNIGHT EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $108K |
| SELLWOOD EIN 80-1827237 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $107K |
| GERROLD EATON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $103K |
| KEVIN SMALLEY EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $103K |
| STEVEN HALL EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $101K |
| MICHAEL JUAREZ EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $100K |
| AMY LIVINGSTONE EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $98K |
| LORETTA J DOOLEY EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| TERESA L CONDON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $88K |
| VANESSA PINEDA EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $87K |
| TONI GURULE EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| ERIKA MENDEZ EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| QUALITY LOGO PRODUCTS NONE | Other services; Direct payment from the plan Service code 49 | 724 NORTH HIGHLAND AVENUE AURORA, IL 60506 | $81K |
| JANET L SANDS EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Direct payment from the plan; Consulting (general); Actuarial Service code 11 | — | $80K |
| MICHAEL SMALLEY NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Consulting (general) Service code 16 | PO BOX 2071 FREDERICKSBERG, TX 78624 | $73K |
| CARLEY JA'NICE EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| HYSSOP, INC EIN 38-4166792 NONE | Direct payment from the plan; Other services Service code 49 | — | $69K |
| KAILYNN NEWSON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| MEREDITH KING EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $65K |
| COMMERCE PRINTING EIN 61-0168958 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $55K |
| COLBEY GONSALVES EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $53K |
| VICTORIA DAVIS EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $36K |
| CONNIE QUARTIER EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $35K |
| MICHELLE L SAIENNI EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $34K |
| WITHUMSMITH+BROWN PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $34K |
| R.G. BUILDING MAINTENANCE NONE | Other services; Direct payment from the plan Service code 49 | 2701 DEL PASO ROAD 130-260 SACRAMENTO, CA 95835 | $33K |
| NEXTIVA NONE | Direct payment from the plan; Other services Service code 49 | 9451 EAST VIA DE VENTURA SCOTTSDALE, AZ 85256 | $31K |
| MELISSA ORTIZ EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| PREMIER PRINT & MAIL NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 2615 DEL MONTE ST WEST SACRAMENTO, CA 95691 | $23K |
| ARMIN INNOVATIVE PRODUCTS NONE | Other services; Direct payment from the plan Service code 49 | 1424 SOMERSET AVE DIGHTON, MA 02715 | $22K |
| PMSI NONE | Direct payment from the plan; Other services Service code 49 | 300 LONG BEACH BLVD. SUITE 6 STRATFORD, CT 06615 | $22K |
| NORTHWEST PLAN SERVICES EIN 91-2090931 NONE | Consulting (pension); Actuarial; Direct payment from the plan Service code 11 | — | $22K |
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 | 27,720 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16,121 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 43,841 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TRIADA ASSURANCE HOLDINGS LLC | 7,862 | $5.1M |
| Life insurance(6 contracts, 3 carriers) | NEW YORK LIFE INSURANCE COMPANY | 21,138 | $7.1M |
| Short-term disability | TRIADA ASSURANCE HOLDINGS LLC | 7,862 | $5.1M |
| Other(4 contracts, 3 carriers) | U.S. LEGAL SERVICES OF WISCONSIN, INC. | 4,103 | $772K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21,138 | — |
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.