| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN | — | — | $0 | 0.00% |
| NONE | — | BLUE SHIELD OF CALIFORNIA | — | — | $0 | 0.00% |
| NONE | — | TOKIO MARINE HCC STOP LOSS GROUP | — | — | $0 | 0.00% |
| NONE | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | AETNA | — | — | $0 | 0.00% |
| NONE | — | MANAGED HEALTH NETWORK | — | — | $0 | 0.00% |
| NONE | — | MES VISION | — | — | $0 | 0.00% |
| NONE | — | MHN SERVICES | — | — | $0 | 0.00% |
| NONE | — | MANAGED HEALTH NETWORK | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORCORAN ADMINISTRATORS NONE | Direct payment from the plan; Copying and duplicating; Contract Administrator Service code 13 | 3313 VINCENT ROAD, SUITE 216 PLEASANT HILL, CA 94523 | $439K |
| RAEL AND LETSON EIN 94-1701048 NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | — | $162K |
| EPLAN EIN 20-3720767 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $60K |
| CIGNA NONE | Direct payment from the plan; Claims processing Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $46K |
| BLUE CROSS NONE | Claims processing; Direct payment from the plan Service code 12 | 225 NORTH MICHIGAN AVEN CHICAGO, IL 60601 | $39K |
| VAVRINEK, TRINE, DAY & CO., LLP EIN 95-2648289 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $36K |
| US BANK NONE | Custodial (securities) Service code 19 | 80 S 8TH STREET, SUITE 224 MINNEAPOLIS, MN 55402 | $31K |
| UNION BANK EIN 94-0304288 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $27K |
| GILBERT & SACKMAN EIN 95-2906951 NONE | Legal Service code 29 | — | $21K |
| VISON SERVICE PLAN NONE | Claims processing; Direct payment from the plan Service code 12 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $19K |
| MICHAEL SUROWITZ COMPLIANCE VERIFIC NONE | Accounting (including auditing) Service code 10 | 23438 BALMORAL LANE WEST HILLS, CA 91307 | $18K |
| WILKINSON BENEFIT CONSULTANTS NONE | Consulting (general) Service code 16 | 1812 W. BURBANK BLVD. SUITE 143 BURBANK, CA 91506 | $13K |
| LAURENCE BEAR EIN 95-2755074 TRUSTEE | Trustee (individual) Service code 20 | — | $8K |
| JACK MORCK EIN 95-2755074 TRUSTEE | Trustee (individual) Service code 20 | — | $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 | 1,026 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 439 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN | 2,231 | $16.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,575 | $251K |
| Vision | MES VISION | 866 | $127K |
| Life insurance | AETNA | 1,780 | $165K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 1,044 | $5.5M |
| Other(3 contracts, 3 carriers) | TOKIO MARINE HCC STOP LOSS GROUP | 1,780 | $590K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,231 | — |
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.