| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER PERMANENTE | — | — | $0 | 0.00% |
| NONE | — | BLUE SHIELD OF CALIFORNIA | — | — | $0 | 0.00% |
| NONE | — | DELTA DENTAL | — | — | $0 | 0.00% |
| NONE | — | DELTACARE | — | — | $0 | 0.00% |
| PACFED INSURANCE SERVICES, INC.3 Filed as: PACFED INSURANCE SERVICES INC | 1000 N CENTRAL AVE, SUITE 400 GLENDALE, CA 91202 | GERBER LIFE INSURANCE CO. | $1K | — | $1K | 6.00% |
| NONE | — | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACFED BENEFIT ADMINISTRATORS EIN 95-4353570 NONE | Employee (plan); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1000 N CENTRAL AVE, SUITE 400 GLENDALE, CA 91202 | $463K |
| LEVY PHILLIPS APC EIN 95-4536532 NONE | Legal; Direct payment from the plan Service code 29 | 20700 VENTURA BLVD, SUITE 320 WOODLAND HILLS, CA 91364 | $46K |
| MCMORGAN COMPANY EIN 94-1650768 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 3500 W OLIVE, SUITE 690 BURBANK, CA 91505 | $42K |
| BUCHALTER EIN 95-2640846 NONE | Legal; Direct payment from the plan Service code 29 | 1000 WILSHIRE BLVD, SUITE 1500 LOS ANGELES, CA 90017 | $35K |
| MILLIMAN, INC EIN 91-0675641 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $17K |
| EIDE BAILLY EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
| REICH, ADELL & CVITAN EIN 95-3082677 NONE | Legal; Direct payment from the plan Service code 29 | — | $14K |
| NIGRO, KARLIN AND SEGAL EIN 95-3632775 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $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 | 929 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 929 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER PERMANENTE | 268 | $2.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL | 205 | $162K |
| Vision | GERBER LIFE INSURANCE CO. | 301 | $22K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 929 | $5K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 127 | $1.3M |
| Other(2 contracts, 2 carriers) | LANDMARK HEALTHPLAN | 929 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 929 | — |
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.