| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOHRMANN INSURANCE AGENCY3 Filed as: DOHRMANN INSURANCE AGENCY, INC. | PO BOX 7956 STOCKTON, CA 95267 | BLUE CROSS OF CALIFORNIA | $17K | — | $17K | 2.09% |
| LEAVITT GROUP3 Filed as: LEAVITT CENTRAL COAST INS. SVCS | 950 E BLANCO ROAD SUITE 103 SALINAS, CA 93901 | BLUE CROSS OF CALIFORNIA | $17K | — | $17K | 2.04% |
| LEAVITT GROUP3 Filed as: LEAVITT CENTRAL COAST INS SVCS | 950 E BLANCO RD STE 103 SALINAS, CA 93901 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 2.11% |
| DOHRMANN INSURANCE AGENCY3 | PO BOX 7956 STOCKTON, CA 95267 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 1.42% |
| ALAINE S. VANNESS3 Filed as: ALAINE S VANNESS | 1217 SOUTH SCHOOL STREET LODI, CA 95240 | AFLAC | $5K | $279 | $5K | 8.64% |
| DAVID B. KITCHEN3 Filed as: DAVID B KITCHEN | 1260 NORTH DUTTON AVENUE SUITE 180 SANTA ROSA, CA 95401 | AFLAC | $1K | $81 | $1K | 2.58% |
| MELEA A MARTINEZ3 | 75 46TH STREET SACRAMENTO, CA 95819 | AFLAC | $490 | $72 | $562 | 1.00% |
| JAMES S SARANTIS3 | 1100 CORPORATE WAY SUITE 100 SACRAMENTO, CA 95831 | AFLAC | $396 | $81 | $477 | 0.85% |
| PETER JAMES SARANTIS3 | 2251 DOUGLAS BOULEVARD SUITE 110 ROSEVILLE, CA 95661 | AFLAC | $253 | — | $253 | 0.45% |
| FELIPE GOVEA3 | 1831 E ORANGE GROVE AVE ORANGE, CA 92867 | AFLAC | $204 | — | $204 | 0.36% |
| DONNA LOUISE DEVINY3 | 11148 NOATAK RIVER CT RANCHO CORDOVA, CA 95670 | AFLAC | $195 | — | $195 | 0.35% |
| GUSTAVO ARRIAGA II3 | 1509 W YOSEMITE AVENUE MANTECA, CA 95337 | AFLAC | $195 | — | $195 | 0.35% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEN INS SVCS | 193 BLUE RAVINE RD SUITE 140 FOLSOM, CA 95630 | AFLAC | $194 | — | $194 | 0.35% |
| ANA PATRICIA ARRIAGA3 | 1509 W YOSEMITE AVE STE A1 MANTECA, CA 95337 | AFLAC | $140 | — | $140 | 0.25% |
| CRAIG A HILL3 | 9587 NICOLE LN ELK GROVE, CA 95758 | AFLAC | $58 | — | $58 | 0.10% |
| KARA L KRUPP3 | 654 ISLAY ST SAN LUIS OBISPO, CA 93401 | AFLAC | $45 | — | $45 | 0.08% |
| ROBERT BENEFIEL3 | 207 N GILBERT RD STE 001 GILBERT, AZ 85234 | AFLAC | $44 | — | $44 | 0.08% |
| BARRY A WHITE3 | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $43 | — | $43 | 0.08% |
| STEVEN L MITCHELL3 | 2529 COTTONWOOD DR LODI, CA 95242 | AFLAC | $37 | — | $37 | 0.07% |
| SUZI F POST3 | 1558 STANTON WAY STOCKTON, CA 95207 | AFLAC | $33 | — | $33 | 0.06% |
| TYLER BENNETT3 Filed as: TYLER M BENNETT | 2280 E BIDWELL ST SUITE 200 FOLSOM, CA 95630 | AFLAC | $31 | — | $31 | 0.06% |
| DERREK LYN KECK3 | 17809 COUNTRYSIDE CT SALINAS, CA 93907 | AFLAC | $29 | — | $29 | 0.05% |
| JOHN EDWARD SYLER JR3 | 3347 MCDOUGALD BLVD STOCKTON, CA 95208 | AFLAC | $27 | — | $27 | 0.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVS NO CA | 3247 W MARCH LN SUITE 210 STOCKTON, CA 95219 | AFLAC | $20 | — | $20 | 0.04% |
| GUSTAVO ARRIAGA II3 | 5713 N PERSHING AVE SUITE C4 STOCKTON, CA 95207 | AFLAC | $19 | — | $19 | 0.03% |
| BERNARD VIGIL3 | 1816 W KETTLEMAN LN STE D LODI, CA 95242 | AFLAC | $17 | — | $17 | 0.03% |
| MICHAEL E. TRIGUEIRO3 Filed as: MICHAEL E TRIGUEIRO | 7618 COLD MTN CONVERSE, TX 78109 | AFLAC | $13 | — | $13 | 0.02% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEN INS SVCS | 193 BLUE RAVINE RD STE 140 FOLSOM, CA 95630 | AFLAC | $9 | — | $9 | 0.02% |
| MICHELLE LAMPERT3 Filed as: MICHELLE T DUBE | 2265 RIVER PLAZA DR APT 209 SACRAMENTO, CA 95833 | AFLAC | $6 | — | $6 | 0.01% |
| WESTERN VALLEY INS ASSOC3 | PO BOX 1845 TURLOCK, CA 95381 | AFLAC | $5 | — | $5 | 0.01% |
| DOUGLAS E FOX3 | 735 S GARFIELD AVE SUITE 203 TRAVERSE CITY, MI 49686 | AFLAC | $4 | — | $4 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 3247 W MARCH LN SUITE 210 STOCKTON, CA 95219 | AFLAC | $4 | — | $4 | 0.01% |
No Schedule C service providers reported on this filing.
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 | 162 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 162 | $1.4M |
| Vision | BLUE CROSS OF CALIFORNIA | 162 | $825K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 162 | $825K |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 162 | $881K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.