| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE SUITE 1024 ROCKLIN, CA 95677 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 2.34% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B 125 PLACERVILLE, CA 95667 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 2.34% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B 125 PLACERVILLE, CA 95667 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 3.00% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE SUITE 1024 ROCKLIN, CA 95677 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 2.77% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SOUTHEAST SUITE 1950 ATLANTA, GA 30339 | KAISER FOUNDATION HEALTH PLAN, INC. | $3 | — | $3 | 0.00% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B125 PLACERVILLE, CA 95667 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14K | — | $14K | 25.66% |
| COLLEEN LEWIS3 | 16676 NEW YORK HOUSE ROAD BROWNSVILLE, CA 95919 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | — | $10K | 18.44% |
| COLLEEN LEWIS3 | 16676 NEW YORK HOUSE ROAD BROWNSVILLE, CA 95919 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 7.22% |
| KATHY SAM RUTH RUMBAUGH3 | 1390 BROADWAY SUITE B125 PLACERVILLE, CA 95667 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 4.31% |
| DEBORAH L SENN3 Filed as: DEBORAH L TURPIN | 316 NORTH LEXINGTON DRIVE FOLSOM, CA 95630 | CONTINENTAL AMERICAN INSURANCE COMPANY | $883 | — | $883 | 1.61% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B 125 PLACERVILLE, CA 95667 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 7.62% |
| CLIFFORD BENEFITS GROUP3 Filed as: CLIFFORD BENEFITS GROUP DBA EUREKA | 4465 GRANITE DRIVE SUITE 1027 ROCKLIN, CA 95677 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 2.38% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 | 1390 BROADWAY SUITE B # 125 PLACERVILLE, CA 95667 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 | 1390 BROADWAY SUITE B # 125 PLACERVILLE, CA 95667 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $446 | — | $446 | 10.00% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 56 | $510K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 97 | $45K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 97 | $45K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $27K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 166 | $55K |
| Other(3 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 166 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.