| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAEL & LETSON3 | 2929 CAMPUS DR STE 400 SAN MATEO, CA 94403 | HM LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $393K |
| OPTUM RX EIN 33-0441200 NONE | Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $74K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan; Investment management; Custodial (securities) Service code 19 | — | $70K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $56K |
| ANTHEM BLUE CROSS LIFE AND H.I. CO. EIN 95-4331852 NONE | Other services; Claims processing Service code 12 | — | $53K |
| WOHLNER KAPLON CUTLER HALFORD ET AL EIN 83-2856417 NONE | Legal; Direct payment from the plan Service code 29 | — | $31K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $25K |
| MICHAEL SUROWITZ EIN 26-2336426 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| VSP EIN 94-1632821 NONE | Other services Service code 49 | — | $15K |
| FIRST DENTAL HEALTH EIN 33-0655193 NONE | Other services; Direct payment from the plan Service code 49 | — | $12K |
| MEDEXPERT INTERNATIONAL, INC. NONE | Consulting (general) Service code 16 | P.O. BOX 7550 MENLO PARK, CA 94026 | $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 | 911 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 72 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 983 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,372 | $9.6M |
| Dental(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 876 | $3.6M |
| Vision | VISION SERVICE PLAN | 978 | $95K |
| Life insurance(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 894 | $154K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 1,372 | $6.2M |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 270 | $546K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 894 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,372 | — |
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.