| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAEL & LETSON4 | DEPT LA 24736 PASADENA, CA 91185 | HEALTH NET | $20K | — | $20K | 1.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION ROOFERS ADMINISTRATIVE EIN 95-2159333 PARTY-IN-INTEREST | Plan Administrator; Contract Administrator; Direct payment from the plan Service code 13 | — | $519K |
| MCMORGAN & COMPANY EIN 52-2334338 NONE | Direct payment from the plan; Investment management Service code 28 | — | $112K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $32K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $30K |
| CYNTHIA GRAYDON EIN 56-2455975 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $22K |
| REAL & LETSON | Direct payment from the plan; Actuarial Service code 11 | — | $20K |
| DECARLO SHANLEY APC EIN 95-4022565 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| MICHAEL SUROWITZ COMPLIANCE EIN 26-2336426 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $11K |
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 | 1,147 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 128 | $1.5M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 1,284 | $338K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 677 | $1.5M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE | 1,123 | $337K |
| Other | STANDARD INSURANCE COMPANY | 189 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,402 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.