| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN | $10K | $0 | $10K | 0.73% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN | $7K | $0 | $7K | 0.52% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | WESTERN HEALTH ADVANTAGE | $29K | — | $29K | 5.00% |
| CELITA ANN PEDRO3 | 6705 MIRAVISTA DR ROCKLIN, CA 95677 | AFLAC | $3K | $32 | $3K | 4.91% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INS SVCS INC | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | AFLAC | $899 | — | $899 | 1.52% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK RD FL 2 RANCHO CORDOVA, CA 95670 | AFLAC | $418 | $418 | $836 | 1.42% |
| JACE G KUERSTEN3 | 1574 SAN FERNANDO DR CORONA, CA 92882 | AFLAC | $647 | — | $647 | 1.10% |
| RONDA MATHEW3 | 2030 13TH ST APT 3 SACRAMENTO, CA 95818 | AFLAC | $277 | $74 | $351 | 0.59% |
| ANDY B GLENN II3 | 2999 DOUGLAS BLVD SUIE 180 ROSEVILLE, CA 95661 | AFLAC | $226 | $50 | $276 | 0.47% |
| PETER JAMES SARANTIS3 | 7775 DUTRA BEND DR SACRAMENTO, CA 95831 | AFLAC | $222 | — | $222 | 0.38% |
| PETER JAMES SARANTIS3 | 7775 DUTRA BEND DR SACRAMENTO SACRAMENTO, CA 95831 | AFLAC | — | $222 | $222 | 0.38% |
| JAMES S SARANTIS3 | 14132 SE FIRCREST CT PORTLAND, OR 97236 | AFLAC | $214 | — | $214 | 0.36% |
| MARCI MARIE OTIS3 | 200 JULINA LN ROSEBURG, OR 97471 | AFLAC | $214 | — | $214 | 0.36% |
| LARS J RONTEN | 3178 SOFIA DR LINCOLN, CA 95648 | AFLAC | $197 | — | $197 | 0.33% |
| LEE C GARLAND3 | 398 ALBERTON CIR LINCOLN, CA 95648 | AFLAC | $100 | — | $100 | 0.17% |
| AUSTIN J RICE3 | 205 PERSIMMON TRL WOODSTOCK, GA 30188 | AFLAC | $90 | — | $90 | 0.15% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE CTR | PO BOX 734004 CHICAGO, IL 60673 | AFLAC | $67 | — | $67 | 0.11% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | — | $49 | $49 | 0.08% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $46 | — | $46 | 0.08% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS SERV LLC | 1455 RESPONSE RD STE 260 SACRAMENTO, CA 95815 | AFLAC | $41 | — | $41 | 0.07% |
| LAWLEN INSURANCE SOLUTIONS, LLC3 Filed as: LAWLEN INSURANCE SOLUTIONS LLC | 1901 66TH AVE SACRAMENTO, CA 95822 | AFLAC | $39 | — | $39 | 0.07% |
| RYAN OLSON3 Filed as: RYAN T OLSON | 1140 MANGROVE AVE STE D CHICO, CA 95926 | AFLAC | $36 | — | $36 | 0.06% |
| DARRYL W VIDOR3 | 3314 EUROPA ST ROSEVILLE, CA 95661 | AFLAC | — | $25 | $25 | 0.04% |
| ROBERT WILKINS3 Filed as: ROBERT D WILKINS | 2685 BAYBERRY DR FRUITLAND, ID 83619 | AFLAC | $22 | — | $22 | 0.04% |
| APRIL MARIE ROBERTS3 | 3540 SPRINGFIELD DR FAIRFIELD, CA 94534 | AFLAC | — | $20 | $20 | 0.03% |
| DANNY J LEON3 | 10550 BAYMEADOWS RD UNIT 429 JACKSONVILLE, FL 32256 | AFLAC | $17 | — | $17 | 0.03% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 229 MCKAYS POINT PL WEST SACRAMENTO, CA 95605 | AFLAC | $10 | — | $10 | 0.02% |
| SLR INSURANCE SOLUTIONS INC3 | 179 PINE HAVEN DR ST JOHNS, FL 32259 | AFLAC | $8 | — | $8 | 0.01% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DR SANTA ROSA, CA 95403 | AFLAC | $7 | — | $7 | 0.01% |
| MARK C. HUBER3 Filed as: MARK C HUBER | 1100 COLD SPRINGS RD PLACERVILLE, CA 95667 | AFLAC | — | $6 | $6 | 0.01% |
| DERREK LYN KECK3 | 18080 DAMIAN WAY SALINAS, CA 93907 | AFLAC | $5 | — | $5 | 0.01% |
| DAVID B. KITCHEN3 Filed as: DAVID B KITCHEN | 5230 HARTER LN LA CANADA FLINTRIDGE, CA 91011 | AFLAC | $4 | — | $4 | 0.01% |
| NICHOLAS E VIGIL3 | 7808 E CYPRESS ST SCOTTSDALE, AZ 85257 | AFLAC | $4 | — | $4 | 0.01% |
| WILLIAM A WEST3 | PO BOX 765 PALO CEDRO, CA 96073 | AFLAC | $1 | — | $1 | 0.00% |
| KELLY E TIMS3 | 866 REDWOOD BLVD REDDING, CA 96003 | AFLAC | $1 | — | $1 | 0.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 7.45% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES | PO BOX 66119 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.16% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $215 | $110 | $325 | 0.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC - WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $306 | — | $306 | 0.71% |
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 | 328 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN | 248 | $1.9M |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 328 | $102K |
| Short-term disability | AFLAC | 61 | $59K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN | 248 | $1.9M |
| Other(2 contracts, 2 carriers) | AFLAC | 328 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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."
No prospect flags tripped on this filing.