| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY KAY3 | 14135 RIVERSIDE DR #2 SHERMAN OAKS, CA 91423 | CALIFORNIA DENTAL NETWORK, INC. | $898 | — | $898 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS, INC. EIN 52-1590516 NONE | Plan Administrator; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Claims processing; Direct payment from the plan Service code 10 | — | $1.2M |
| ZELIS CLAIMS INTEGRITY, INC. EIN 86-1040704 NONE | Other fees; Direct payment from the plan Service code 50 | — | $399K |
| ZENITH AMERICAN SOLUTIONS | Other fees Service code 99 | — | $203K |
| PACIFIC INCOME ADVISORS EIN 95-4067974 NONE | Direct payment from the plan; Investment management fees paid directly by plan Service code 50 | — | $76K |
| A.F. BUBENAS & CO. INC EIN 95-2368103 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $72K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Other services; Float revenue; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $69K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $62K |
| MUFG UNION BANK, N.A. EIN 94-0304228 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $42K |
| REICH ADELL & CVITAN EIN 95-3082677 NONE | Legal; Direct payment from the plan Service code 29 | — | $27K |
| US BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $17K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $13K |
| WOHLNER KAPLON CUTLER HALFORD & ROS EIN 83-2856417 NONE | Legal; Direct payment from the plan Service code 29 | — | $13K |
| IRON MOUNTAIN, INC. EIN 23-2588479 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $10K |
| PACIFIC CREST ACTUARIES EIN 81-4642259 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $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 | 546 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 166 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 712 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 887 | $8.3M |
| Dental(2 contracts, 2 carriers) | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | 410 | $84K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 513 | $20K |
| Prescription drug | UNITED AMERICAN INSURANCE COMPANY | 58 | $191K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 169 | $1.0M |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 513 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 887 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.