| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFITS PROGRAM ADMINISTRATION EIN 13-2501278 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $119K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $46K |
| WOHLNER, KAPLON, PHILLIPS YOUNG & C EIN 95-4177931 NONE | Legal; Direct payment from the plan; Other services Service code 29 | — | $35K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
| RUBEN RICO EIN 95-3136353 TRUSTEE | Trustee (individual) Service code 20 | — | $5K |
| DUCENTA SQUARED ASSET MANAGEMENT EIN 85-0584508 NONE | Investment management; Direct payment from the plan Service code 28 | — | $5K |
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 | 713 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 713 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 1,643 | $232K |
| Vision | VISION SERVICE PLAN | 681 | $57K |
| Life insurance | UNITED HEALTHCARE | 682 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,715 | — |
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."
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.