| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY KAY3 | 14315 RIVERSIDE DR #2 SHERMAN OAKS, CA 91423 | CALIFORNIA DENTAL NETWORK, INC. | $950 | — | $950 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS, INC. EIN 52-1590516 NONE | Contract Administrator; Plan Administrator; Other fees; Accounting (including auditing); Claims processing; Direct payment from the plan Service code 10 | — | $1.3M |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Float revenue; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing Service code 12 | — | $121K |
| QUEST INVESTMENT MANAGEMENT, LLC NONE | Investment management fees paid directly by plan; Direct payment from the plan Service code 50 | 5335 MEADOWS RD STE 400 LAKE OSWEGO, OR 97035 | $99K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $82K |
| A.F. BUBENAS & CO. INC EIN 95-2368103 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $74K |
| BUSH GOTTLIEB, A LAW CORPORATION NONE | Legal; Direct payment from the plan Service code 29 | 801 N BRAND BLVD STE 950 GLENDALE, CA 91203 | $56K |
| PHARMACY BENEFIT SOLUTIONS, INC NONE | Consulting (general); Direct payment from the plan Service code 16 | PO BOX 5395 371 NEVADA STREET AUBURN, CA 956045395 | $41K |
| US BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $23K |
| WOHLNER KAPLON CUTLER HALFORD & ROS EIN 83-2856417 NONE | Legal; Direct payment from the plan Service code 29 | — | $18K |
| REICH ADELL & CVITAN EIN 95-3082677 NONE | Legal; Direct payment from the plan Service code 29 | — | $16K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $9K |
| MILLIMAN, INC. EIN 91-0675641 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $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 | 634 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 94 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 728 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 809 | $9.8M |
| Dental(2 contracts, 2 carriers) | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | 357 | $81K |
| Vision | VISION SERVICE PLAN | 710 | $74K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 592 | $22K |
| Prescription drug | UNITED AMERICAN INSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 238 | $1.4M |
| Other(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 592 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 809 | — |
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.