| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY KAY3 | 14315 RIVERSIDE DR #2 SHERMAN OAKS, CA 91423 | CALIFORNIA DENTAL NETWORK, INC. | $863 | — | $863 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS, INC. EIN 52-1590516 NONE | Other fees; Plan Administrator; Claims processing; Contract Administrator; Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $1.3M |
| PACIFIC INCOME ADVISORS EIN 95-4067974 NONE | Investment management fees paid directly by plan; Direct payment from the plan Service code 50 | — | $103K |
| A.F. BUBENAS & CO. INC EIN 95-2368103 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $73K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Direct payment from the plan; Contract Administrator Service code 12 | — | $72K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $57K |
| REICH ADELL & CVITAN EIN 95-3082677 NONE | Legal; Direct payment from the plan Service code 29 | — | $46K |
| MUFG UNION BANK, N.A. EIN 94-0304228 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $46K |
| US BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $22K |
| WOHLNER KAPLON CUTLER HALFORD & ROS EIN 83-2856417 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| MILLIMAN, INC. EIN 91-0675641 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $15K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $10K |
| DODGE DATA AND ANALYTICS NONE | Direct payment from the plan; Other services Service code 49 | 300 AMERICAN METRO BLVD STE 185 HAMILTON, NJ 08619 | $7K |
| IRON MOUNTAIN NONE | Other services; Direct payment from the plan Service code 49 | 1201 N 96TH ST SEATTLE, WA 98103 | $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 | 567 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 112 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 679 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 837 | $11.2M |
| Dental(2 contracts, 2 carriers) | CALIFORNIA DENTAL NETWORK, INC. | 64 | $17K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 603 | $22K |
| Prescription drug | UNITED AMERICAN INSURANCE COMPANY | 50 | $193K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 226 | $1.3M |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 603 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 837 | — |
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.