| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC | 18700 N HAYDEN ROAD STE 405 SCOTTSALE, AZ 85255 | HCC LIFE INSURANCE COMPANY | $25K | — | $25K | 5.00% |
| INTERREMEDY INSURANCE SERVICES | 2268 WESTBOROUGH BLVD STE 302-328 SOUTH SAN FRANCISCO, CA 94080 | INTERREMEDY | $8K | — | $8K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS ADMINISTRATORS, INC. EIN 38-2383171 NONE | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 12 | — | $425K |
| HORIZON ACTUARIAL SERVICES EIN 26-1370698 NONE | Actuarial; Consulting (general) Service code 11 | — | $115K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general) Service code 16 | — | $95K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | — | $92K |
| SEYFARTH SHAW LLP EIN 36-2152202 NONE | Legal Service code 29 | — | $59K |
| WOHLNER KAPLON CUTLER HALFORD & ROS EIN 83-2856417 NONE | Legal Service code 29 | — | $49K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Other fees; Float revenue; Claims processing Service code 12 | — | $34K |
| UPRISE HEALTH (FORMERLY HMC) EIN 75-3189468 NONE | Other services Service code 49 | — | $32K |
| HENNINGFIELD & ASSOCIATES, INC. EIN 54-2189926 NONE | Accounting (including auditing) Service code 10 | — | $31K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing Service code 12 | — | $23K |
| UNION BANK EIN 94-0304288 NONE | Other services Service code 49 | — | $12K |
| BARRY S. MITCHELL, DDS EIN 95-3919508 NONE | Consulting fees Service code 70 | — | $7K |
| SOUTHWEST MONEY MANAGEMENT EIN 95-6055492 NONE | Investment advisory (plan) Service code 27 | — | $7K |
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 | 1,421 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 280 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,701 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 3,574 | $19.6M |
| Dental | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | 923 | $124K |
| Vision | VISION SERVICE PLAN | 1,404 | $185K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 343 | $670K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,574 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.