No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Contract Administrator; Plan Administrator Service code 13 | — | $324K |
| OPTUM RX EIN 33-0441200 NONE | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $283K |
| ANTHEM BLUE CROSS LIFE AND H.I. CO. EIN 95-4331852 NONE | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $59K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | — | $52K |
| US BANK EIN 31-0841368 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $50K |
| WOHLNER KAPLON CUTLER HALFORD ET AL EIN 95-4177931 NONE | Legal; Direct payment from the plan Service code 29 | — | $42K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $35K |
| MICHAEL SUROWITZ EIN 26-2336426 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $12K |
| FIRST DENTAL HEALTH EIN 33-0655193 NONE | Other services Service code 49 | — | $10K |
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 | 808 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 81 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 889 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,384 | $9.0M |
| Dental(2 contracts, 2 carriers) | UNITED HEALTHCARE OF CALIFORNIA | 1,264 | $1.4M |
| Vision | VISION SERVICE PLAN | 895 | $102K |
| Life insurance(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 824 | $179K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,384 | $6.2M |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 156 | $342K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,384 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.