No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| XEROX CORP EIN 16-0468020 NONE | Account maintenance fees Service code 65 | — | $123K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Account maintenance fees Service code 65 | — | $31K |
| ANTHEM BLUE CROSS LIFE AND HEALTH I EIN 95-4331852 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services Service code 12 | — | $19K |
| DELTA DENTAL EIN 94-1461312 NONE | Account maintenance fees; Claims processing Service code 12 | — | $9K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,629 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1,168 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,797 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 701 | $7.6M |
| Dental | BLUE CROSS OF CALIFORNIA | 278 | $1.6M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,542 | $742K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURNACE COMPANY | 96 | $12K |
| Other(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 701 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,542 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.