| 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 | — | $635K | $635K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $626K | $626K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $560K | $560K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $55K | $55K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $48K | $48K | 25.00% |
| CCPOA BENEFIT TRUST FUND5 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | NEW YORK LIFE INSURANCE COMPANY | — | $24K | $24K | 25.00% |
| DOUG BORG3 | 42425 JACKSON ST C104 INDIO, CA 92203 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $184 | — | $184 | 3.91% |
| JEFFREY REYNOLDS3 | 2515 VENTURE OAKS WAY SUITE 200 SACRAMENTO, CA 95833 | JACKSON NATIONAL LIFE INSURANCE COMPANY | $47 | — | $47 | 15.02% |
| 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 | — | $301K |
| GUADALUPE RUIZ EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $278K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $267K |
| DANIEL BEAMAN EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $259K |
| JAMES BAUMILLER EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $239K |
| SHANA POWELL EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $161K |
| PITNEY BOWES NONE | Copying and duplicating; Direct payment from the plan Service code 36 | P.O. BOX 981039 BOSTON, MA 022981039 | $160K |
| DEBORAH JOHNSON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $155K |
| PETER SANDS EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $151K |
| JORDAN BARGAS EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $140K |
| ANGELA MURILLO EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $136K |
| SHALLY SINGH EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $129K |
| SELLWOOD CONSULTING LLC EIN 80-0827237 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $120K |
| JOTI CHAND EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $120K |
| LYNN NOLAND EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $119K |
| KATHRYN KNIGHT EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $118K |
| MICHAEL JUAREZ EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $117K |
| MELISSA GRANDY EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $117K |
| MARIETTA TANGUILEG EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $116K |
| KEVIN SMALLEY EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $114K |
| COMMERCE PRINTING EIN 61-0168958 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $111K |
| VERONICA SAMPSON EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $111K |
| TRUCKER HUSS, APC EIN 94-3216063 NONE | Legal; Direct payment from the plan Service code 29 | — | $110K |
| GERROLD EATON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $106K |
| AMY LIVINGSTONE EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| STEVEN HALL EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| LORETTA DOOLEY EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| TONI GURULE EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| TERESA CONDON EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| HYSSOP INC EIN 38-4166792 NONE | Other services; Direct payment from the plan Service code 49 | — | $94K |
| MELISSA ORTIZ EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $94K |
| ERIKA MENDEZ EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| THE SEGAL COMPANY (WESTERN STATES) EIN 94-1503999 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $87K |
| COLBEY GONSAVLES EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| JA'NICE CARLEY EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| KAILYNN NEWSON EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| NESTOR FARIAS EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $78K |
| MEREDITH KING EIN 94-6459649 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $72K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $43K |
| SOFTCHOICE CORPORATION NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 915 BROADWAY SUITE 1005 NEW YORK, NY 10010 | $42K |
| QUALITY LOGO PRODUCTS NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 724 NORTH HIGHLAND AVENUE AURORA, IL 60506 | $40K |
| ZELIS PAYMENTS HOLDINGS, LLC EIN 84-3069529 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $39K |
| 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 |
| MICHAEL SMALLEY NONE | Consulting (general); Direct payment from the plan; Insurance agents and brokers Service code 16 | PO BOX 2071 FREDERICKSBURG, TX 78624 | $30K |
| TAKI BRANDON EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| BLYTHECO INC EIN 33-0784232 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $27K |
| PASHILA LY EIN 94-6459649 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $27K |
| GARY AUSTIN ADVERTISING NONE | Other services; Direct payment from the plan Service code 49 | 36 EMERALD LAKE DRIVE JACKSON, TN 38305 | $26K |
| NEXTIVA NONE | Direct payment from the plan; Other services Service code 49 | 9451 EAST VIA DE VENTURA SCOTTSDALE, AZ 85256 | $25K |
| NORTHWEST PLAN SERVICES EIN 91-2090931 NONE | Actuarial; Direct payment from the plan; Consulting (pension) Service code 11 | — | $24K |
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 | 27,468 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16,727 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 44,195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TRIADA ASSURANCE HOLDINGS LLC | 8,063 | $4.8M |
| Life insurance(6 contracts, 3 carriers) | NEW YORK LIFE INSURANCE COMPANY | 20,271 | $7.4M |
| Short-term disability | TRIADA ASSURANCE HOLDINGS LLC | 8,063 | $4.8M |
| Other(4 contracts, 3 carriers) | U.S. LEGAL SERVICES OF WISCONSIN, INC. | 4,548 | $788K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 20,271 | — |
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.