| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | CALIFORNIA CHOICE | $44K | — | $44K | 4.49% |
| RIPPLING INSURANCE SERVICES INC3 | 300 SOUTH DUVAL STREET, SUITE 410 TALLAHASSEE, FL 32301 | CALIFORNIA CHOICE | $5K | — | $5K | 0.48% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 225 KENNETH DRIVE ROCHESTER, NY 14623 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | $6K | $21K | 13.91% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $5K | $11K | 7.39% |
| RIPPLING INSURANCE SERVICES INC3 | 300 SOUTH DUVAL STREET, SUITE 410 TALLAHASSEE, CA 32301 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.01% |
| BRITTNEY GRACE MAAS3 | 127 ADELAIDE XING ACWORTH, GA 30101 | AFLAC | $196 | $0 | $196 | 5.26% |
| MARIETTE LASLEY3 | 15 WEDGEFIELD XING SAVANNAH, CA 31405 | AFLAC | $104 | $0 | $104 | 2.79% |
| LEON NORMAN DAVIDSON3 | 1230 ARROYO GRANDE DRIVE SACRAMENTO, CA 95864 | AFLAC | $75 | $0 | $75 | 2.01% |
| JAYSON C ROCHA3 Filed as: JAYSON ROCHA | 3577 SAINT JOHN ROAD WEST SACRAMENTO, CA 95691 | AFLAC | $52 | $0 | $52 | 1.40% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | AFLAC | $41 | $0 | $41 | 1.10% |
| JAMES S SARANTIS3 Filed as: JAMES SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $36 | $0 | $36 | 0.97% |
| MJ INSURANCE3 Filed as: ANDY GLENN AND VARIOUS AGENTS | 2999 DOUGLAS BOULEVARD, SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $36 | $0 | $36 | 0.97% |
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 | 183 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 118 | $992K |
| Dental | AFLAC | 2 | $4K |
| Vision | AFLAC | 2 | $4K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 241 | $150K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 241 | $150K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 241 | $150K |
| Other | AFLAC | 2 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.