| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $25K | $0 | $25K | 1.78% |
| USI INSURANCE SERVICES LLC3 | 575 MARKET STREET, SUITE 3750 SAN FRANCISCO, CA 94105 | WESTERN HEALTH ADVANTAGE | $26K | $0 | $26K | 4.89% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 18.25% |
| ARACELIA PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $1K | $82 | $1K | 5.32% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $816 | $0 | $816 | 3.40% |
| LARS J RONTEN3 Filed as: LARS RONTEN AND OTHER AGENTS | 3178 SOFIA DRIVE LINCOLN, CA 95648 | AFLAC | $390 | $0 | $390 | 1.63% |
| JACE KUERSTEN3 | 7937 EAST JOSHUA TREE LANE SCOTTSDALE, AZ 85250 | AFLAC | $175 | $0 | $175 | 0.73% |
| RONDA MATHEW3 | 2030 13TH STREET, APARTMENT 3 SACRAMENTO, CA 95818 | AFLAC | $146 | $19 | $165 | 0.69% |
| JAMES S SARANTIS3 Filed as: JAMES SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $103 | $0 | $103 | 0.43% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 5509 SNOWBRUSH DRIVE ROCKLIN, CA 95677 | AFLAC | $81 | $0 | $81 | 0.34% |
| ARACELIA PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $674 | $0 | $674 | 4.45% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $303 | $0 | $303 | 2.00% |
| ANDY B GLENN II3 Filed as: ANDY GLENN II AND OTHER AGENTS | 2999 DOUGLAS BOULEVARD, SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $223 | $0 | $223 | 1.47% |
| JACE KUERSTEN3 | 7937 EAST JOSHUA TREE LANE SCOTTSDALE, AZ 85250 | AFLAC | $145 | $0 | $145 | 0.96% |
| MARCI MARIE OTIS3 Filed as: MARCI OTIS | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $106 | $0 | $106 | 0.70% |
| JAMES S SARANTIS3 Filed as: JAMES SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $82 | $0 | $82 | 0.54% |
| RONDA MATHEW3 | 2030 13TH STREET, APARTMENT 3 SACRAMENTO, CA 95818 | AFLAC | $72 | $0 | $72 | 0.48% |
| ARACELIA PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $479 | $0 | $479 | 7.27% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $462 | $0 | $462 | 7.02% |
| ERIC N RAWLINGS3 Filed as: ERIC RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $88 | $0 | $88 | 1.34% |
| JACE KUERSTEN3 | 7937 EAST JOSHUA TREE LANE SCOTTSDALE, AZ 85250 | AFLAC | $84 | $0 | $84 | 1.28% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS AND OTHER AGENTS | 5509 SNOWBRUSH DRIVE ROCKLIN, CA 95677 | AFLAC | $82 | $0 | $82 | 1.25% |
| RONDA MATHEW3 | 2030 13TH STREET, APARTMENT 3 SACRAMENTO, CA 95818 | AFLAC | $49 | $0 | $49 | 0.74% |
| LARS J RONTEN3 Filed as: LARS RONTEN | 3178 SOFIA DRIVE LINCOLN, CA 95648 | AFLAC | $43 | $0 | $43 | 0.65% |
| ARACELIA PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $120 | $0 | $120 | 4.63% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $66 | $0 | $66 | 2.55% |
| JACE KUERSTEN3 | 7937 EAST JOSHUA TREE LANE SCOTTSDALE, AZ 85250 | AFLAC | $62 | $0 | $62 | 2.39% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 5509 SNOWBRUSH DRIVE ROCKLIN, CA 95677 | AFLAC | $29 | $0 | $29 | 1.12% |
| JAMES S SARANTIS3 Filed as: JAMES SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $19 | $0 | $19 | 0.73% |
| ARACELIA PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $66 | $0 | $66 | 3.80% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $45 | $0 | $45 | 2.59% |
| JACE KUERSTEN3 | 7937 EAST JOSHUA TREE LANE SCOTTSDALE, AZ 85250 | AFLAC | $39 | $0 | $39 | 2.24% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 5509 SNOWBRUSH DRIVE ROCKLIN, CA 95677 | AFLAC | $19 | $0 | $19 | 1.09% |
| DANNY LEON3 | 162 BARLEY STREET SAINT AUGUSTINE, FL 32092 | AFLAC | $18 | $0 | $18 | 1.04% |
| JAMES S SARANTIS3 Filed as: JAMES SARANTIS AND OTHER AGENTS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $12 | $0 | $12 | 0.69% |
| SLR INSURANCE SOLUTIONS INC3 Filed as: SLR INSURANCE SOLUTIONS, INC. | 179 PINE HAVEN DRIVE SAINT JOHNS, FL 32259 | AFLAC | $9 | $0 | $9 | 0.52% |
| ARACELIA PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $31 | $0 | $31 | 5.27% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS SERV, LLC | 1455 RESPONSE ROAD, SUITE 260 SACRAMENTO, CA 95815 | AFLAC | $14 | $0 | $14 | 2.38% |
| DARRYL W VIDOR3 Filed as: DARRYL VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | AFLAC | $9 | $0 | $9 | 1.53% |
| APRIL MARIE ROBERTS3 Filed as: APRIL ROBERTS | 3540 SPRINGFIELD DRIVE FAIRFIELD, CA 94534 | AFLAC | $7 | $0 | $7 | 1.19% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEN INS SERVICES, INC. | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $4 | $0 | $4 | 0.68% |
| MICHAEL RHODD3 | 4160 GREEN VALLEY ROAD FAIRFIELD, CA 94534 | AFLAC | $1 | $0 | $1 | 0.17% |
| AMY LUDWICK3 | 229 MCKAYS POINT PLACE WEST SACRAMENTO, CA 95605 | AFLAC | $1 | $0 | $1 | 0.17% |
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 | 302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 259 | $1.9M |
| Life insurance(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 316 | $92K |
| Short-term disability(6 contracts) | AFLAC | 23 | $51K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 259 | $1.9M |
| Other(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 316 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.