| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARGUS HEALTH SYSTEMS INC.0 | 1300 WASHINGTON STREET KANSAS CITY, MO 64105 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $16K | — | $16K | — |
| CDR ASSOCIATES0 | 2828 N. HASKELL DALLAS, TX 75204 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $4K | — | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SCPT ADMINISTRATIVE CORPORATION EIN 95-4557526 ADMINISTRATOR | Contract Administrator Service code 13 | 501 SHATTO PLACE, 5TH FLOOR LOS ANGELES, CA 90020 | $5.3M |
| NATIONAL INVESTMENT SERVICES EIN 80-0169636 NONE | Investment advisory (plan) Service code 27 | P.O. BOX 3110 MILWAUKEE, WI 532013110 | $459K |
| HARMAN PRESS EIN 95-2280466 NONE | Copying and duplicating Service code 36 | 6840 VINELAND AVENUE NORTH HOLLYWOOD, CA 91605 | $316K |
| MILLER, KAPLAN, ARASE & CO EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | 4123 LANKERSHIM BLVD NORTH HOLLYWOOD, CA 91602 | $273K |
| LAQUER,URBAN,CLIFFORD & HODGE, LLP EIN 95-4047729 NONE | Legal Service code 29 | 225 SOUTH LAKE AVE., SUITE 200 PASADENA, CA 91101 | $223K |
| SYSTEMS SOLUTIONS GROUP EIN 52-2357489 NONE | Consulting (general) Service code 16 | 1836 MELWOOD DRIVE GLENDALE, CA 91207 | $148K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial Service code 11 | 35 N. LAKE AVE., SUITE 810 PASADENA, CA 91101 | $136K |
| KAREN PEET NONE | Consulting (general) Service code 16 | 1731 ASPEN VILLAGE WAY WEST COVINA, CA 91791 | $67K |
| ADVANCED INFORMATION TECHNOLOGY EIN 26-1421409 NONE | Consulting (general) Service code 16 | 6281 BEACH BLVD. 106 BUENA PARK, CA 90621 | $62K |
| O'DONOGHUE & O'DONOGHUE EIN 53-0120518 NONE | Legal Service code 29 | 4748 WISCONSIN AVE, N.W. WASHINGTON, DC 20016 | $61K |
| ALLISON CHIN NONE | Consulting (general) Service code 16 | 1370 ORANGE GROVE BLVD. 15 PASADENA, CA 91104 | $35K |
| BERNARD KOTKIN & CO.,LLP EIN 95-2556670 NONE | Accounting (including auditing) Service code 10 | 533 SOUTH FREMONT AVENUE SUITE 820 LOS ANGELES, CA 90071 | $31K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 2 EXECUTIVE CAMPUS, SUITE 400 CHERRY HILL, NJ 08002 | $26K |
| US BANK EIN 31-0841368 NONE | Float revenue; Trustee (bank, trust company, or similar financial institution) Service code 21 | 221 SOUTH FIGUEROA STREET SUITE 210 LOS ANGELES, CA 90012 | $21K |
| RISING MEDICAL SOLUTIONS, LLC EIN 36-4276352 NONE | Consulting (general); Other fees Service code 16 | 325 N. LA SALLE ST. SUITE 600 CHICAGO, IL 60654 | $20K |
| MES PEER REVIEW EIN 38-2193020 NONE | Consulting (general) Service code 16 | 100 MORSE STREET NORWOOD, MA 02062 | $19K |
| MIDAS RECOVERY EIN 95-4406118 NONE | Consulting (general) Service code 16 | P.O. BOX 2036 ANAHEIM, CA 928142036 | $14K |
| NEW ENGLAND PENSION CONSULTANT EIN 04-2927339 NONE | Investment management Service code 28 | 1 MAIN STREET, 8TH FLOOR CAMBRIDGE, MA 02142 | $10K |
| TECHNOCLARITY EIN 95-4836687 NONE | Consulting (general) Service code 16 | 4924 BALBOA BLVD., SUITE 617 ENCINO, CA 91316 | $9K |
| KRAW & KRAW EIN 77-0171216 NONE | Legal Service code 29 | 605 ELLIS STREET SUITE 200 MOUNTAIN VIEW, CA 94043 | $6K |
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 | 5,662 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,688 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 15,442 | $0 |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 15,442 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,442 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.