| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B-125 PLACERVILLE, CA 95667 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | — | $11K | 4.31% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE SUITE 1024 ROCKLIN, CA 95677 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 0.64% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B-125 PLACERVILLE, CA 95667 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | — | $11K | 4.55% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE SUITE 1024 ROCKLIN, CA 95677 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 0.44% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B-125 PLACERVILLE, CA 95667 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13K | — | $13K | 17.59% |
| COLLEEN LEWIS3 | 16676 NEW YORK HOUSE ROAD BROWNSVILLE, CA 95919 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12K | — | $12K | 16.39% |
| KATHY SAM RUTH RUMBAUGH3 | 1390 BROADWAY SUITE B125 PLACERVILLE, CA 95667 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 2.37% |
| COLLEEN LEWIS3 | 16676 NEW YORK HOUSE ROAD BROWNSVILLE, CA 95919 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.52% |
| DEBORAH L SENN3 Filed as: DEBORAH LYNN TURPIN | 316 NORTH LEXINGTON DRIVE FOLSOM, CA 95630 | CONTINENTAL AMERICAN INSURANCE COMPANY | $660 | — | $660 | 0.92% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INSURANCE SOLUTIONS, I | 1390 BROADWAY SUITE B 125 PLACERVILLE, CA 95667 | AMERITAS LIFE INSURANCE CORP. | $5K | — | $5K | 10.00% |
| 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 | $415 | — | $415 | 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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 52 | $516K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 93 | $47K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 93 | $47K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $27K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 140 | $72K |
| Other(3 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 147 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.