| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES3 Filed as: INTERREMEDY INSURANCE SERVICES, LLC | 315 MONTGOMERY ST STE 900 SAN FRANCISCO, CA 94104 | TOKIO MARINE HCC | $22K | — | $22K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CALIFORNIA PHYSICIANS' SERVICE EIN 94-0360524 NONE | Claims processing Service code 12 | — | $334K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing) Service code 10 | — | $131K |
| HORIZON ACTUARIAL SERVICE, LLC EIN 26-1370698 NONE | Actuarial Service code 11 | — | $119K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 NONE | Claims processing Service code 12 | — | $109K |
| EMPLOYEE 7 EIN 95-6041105 NONE | Employee (plan) Service code 30 | — | $79K |
| JACK WILKERSON NONE | Consulting (general); Legal Service code 16 | 3500 W ORANGEWOOD AVE ORANGE, CA 92868 | $76K |
| EMPLOYEE 8 EIN 95-6041105 NONE | Employee (plan) Service code 30 | — | $69K |
| SEYFARTH SHAW, LLP EIN 36-2152202 NONE | Legal Service code 29 | — | $67K |
| EMPLOYEE 1 EIN 95-6041105 NONE | Employee (plan) Service code 30 | — | $58K |
| VSP EIN 94-1632821 NONE | Claims processing Service code 12 | — | $46K |
| CA COALITION OF EMPLOYEE BENEFIT PL EIN 80-0479742 NONE | Claims processing Service code 12 | — | $43K |
| CRYSTAL CLEAR RX NONE | Legal Service code 29 | 19753 E PIKES PEAK AVE STE 103 PARKER, CO 80138 | $39K |
| EMPLOYEE 3 EIN 95-6041105 NONE | Employee (plan) Service code 30 | — | $33K |
| EMPLOYEE 2 EIN 95-6041105 NONE | Employee (plan) Service code 30 | — | $30K |
| EMPLOYEE 10 EIN 95-6041105 NONE | Employee (plan) Service code 30 | — | $25K |
| CPI SOLUTIONS NONE | Consulting (general) Service code 16 | 5999 RIDGEVIEW ST UNIT A CAMARILLO, CA 93012 | $18K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment advisory (plan) Service code 27 | — | $11K |
| WOHLNER, KAPLON, PHILLIPS ET AL EIN 95-4177931 NONE | Legal Service code 29 | — | $11K |
| COMERICA BANK EIN 42-1741646 NONE | Other investment fees and expenses; Other services; Custodial (securities) Service code 19 | — | $7K |
| STATE STREET GLOBAL ADVISOR TR CO EIN 81-4017137 NONE | Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $7K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Consulting (general) Service code 16 | — | $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 | 1,487 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 578 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,065 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,926 | $13.1M |
| Dental | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 1,265 | $235K |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 2,051 | $13.4M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,926 | $13.1M |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC | 558 | $444K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,051 | — |
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.