| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAEL & LETSON3 | DEPT LA 24736 PASADENA, CA 91185 | HEALTH NET | $19K | — | $19K | 1.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION ROOFERS ADMINISTRATIVE FUND EIN 95-2159333 PARTY-IN-INTEREST | Contract Administrator; Plan Administrator; Direct payment from the plan Service code 13 | — | $664K |
| MCMORGAN & COMPANY EIN 52-2334338 NONE OTHER THAN CONTRACT | Direct payment from the plan; Investment management Service code 28 | — | $114K |
| MEDEXPERT INTERNATIONAL NONE OTHER THAN CONTRACT | Consulting (general) Service code 16 | 1300 HANCOCK STREET REDWOOD CITY, CA 94063 | $69K |
| US BANK EIN 31-0841368 NONE OTHER THAN CONTRACT | Direct payment from the plan; Custodial (securities) Service code 19 | — | $30K |
| RAEL & LETSON EIN 94-1701048 NONE OTHER THAN CONTRACT | Direct payment from the plan; Actuarial Service code 11 | — | $29K |
| THE WAGNER LAW FIRM NONE OTHER THAN CONTRACT | Legal; Direct payment from the plan Service code 29 | 17777 CENTER COURT DRIVE N STE 600 CERRITOS, CA 90703 | $28K |
| CYNTHIA GRAYDON EIN 56-2455975 NONE OTHER THAN CONTRACT | Direct payment from the plan; Consulting (general) Service code 16 | — | $22K |
| BALDWIN MOFFITT BEHM. LLP EIN 46-4370753 NONE OTHER THAN CONTRACT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| ROBERT HALF EIN 94-1648752 NONE OTHER THAN CONTRACT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
| MARSH MCLENNAN EIN 36-2668272 NONE OTHER THAN CONTRACT | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $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 | 1,290 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 106 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,396 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 99 | $1.3M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL | 505 | $398K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 876 | $1.4M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE | 1,290 | $406K |
| Other | STANDARD INSURANCE COMPANY | 1,271 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,274 | — |
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.