| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY KAY3 | 14315 RIVERSIDE DR #2 SHERMAN OAKS, CA 91423 | CALIFORNIA DENTAL NETWORK, INC. | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS, INC. EIN 52-1590516 NONE | Other fees; Direct payment from the plan; Contract Administrator; Plan Administrator; Accounting (including auditing); Claims processing Service code 10 | — | $1.3M |
| ZELIS CLAIMS INTEGRITY EIN 86-1040704 NONE | Other fees; Direct payment from the plan Service code 50 | — | $675K |
| PACIFIC INCOME ADVISORS EIN 95-4067974 NONE | Direct payment from the plan; Investment management fees paid directly by plan Service code 50 | — | $91K |
| A.F. BUBENAS & CO. INC EIN 95-2368103 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $72K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 12 | — | $70K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $56K |
| MUFG UNION BANK, N.A. EIN 94-0304228 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $46K |
| REICH ADELL & CVITAN EIN 95-3082677 NONE | Legal; Direct payment from the plan Service code 29 | — | $35K |
| US BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $20K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $10K |
| WOHLNER KAPLON CUTLER HALFORD & ROS EIN 83-2856417 NONE | Legal; Direct payment from the plan Service code 29 | — | $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 | 612 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 149 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 761 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 857 | $8.7M |
| Dental(2 contracts, 2 carriers) | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | 413 | $71K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 587 | $20K |
| Prescription drug | UNITED AMERICAN INSURANCE COMPANY | 58 | $193K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 266 | $1.3M |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 587 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 857 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.