| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITSBAY INSURANCE SOLUTION3 Filed as: BENEFITSBAY INSURANCE SOLUTIONS LLC | PO BOX 1585 FAIR OAKS, CA 95628 | WESTERN HEALTH ADVANTAGE | $8K | — | $8K | 0.50% |
| BENEFITSBAY INSURANCE SOLUTION3 | PO BOX 1585 FAIR OAKS, CA 95628 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 5.96% |
| CRAIG ALLEN HENRY PFAFF3 | 9672 ELMIRA CIR SACRAMENTO, CA 95827 | AFLAC | $4K | $42 | $4K | 7.66% |
| ERIC N RAWLINGS3 | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $986 | — | $986 | 1.70% |
| LEON NORMAN DAVIDSON3 | 1230 ARROYO GRANDE DR SACRAMENTO, CA 95864 | AFLAC | $499 | $10 | $509 | 0.88% |
| DEBORAH L SENN3 | 230 BRIGGS RANCH DR FOLSOM, CA 95630 | AFLAC | $415 | — | $415 | 0.72% |
| DIANA CABRAL RENTCHLER3 | PO BOX 54 WEST SACRAMENTO, CA 95691 | AFLAC | $284 | — | $284 | 0.49% |
| JACE G KUERSTEN3 | 1574 SAN FERNANDO DR CORONA, CA 92882 | AFLAC | $227 | — | $227 | 0.39% |
| DAVID B. KITCHEN3 Filed as: DAVID B KITCHEN | 5230 HARTER LN LA CANADA FLINTRIDGE, CA 91011 | AFLAC | $162 | — | $162 | 0.28% |
| AIMEE L PFAFF3 | 6601 TRILBY CT CITRUS HEIGHTS, CA 95610 | AFLAC | $144 | — | $144 | 0.25% |
| JAMES S SARANTIS3 | 14132 SE FIRCREST CT PORTLAND, OR 97236 | AFLAC | $90 | — | $90 | 0.16% |
| ANDY B GLENN II3 | 2999 DOUGLAS BLVD SUIE 180 ROSEVILLE, CA 95661 | AFLAC | $41 | $10 | $51 | 0.09% |
| ROBERT PILKENTON3 Filed as: ROBERT L PILKENTON | 6643 FM 2187 RD SEALY, TX 77474 | AFLAC | $44 | — | $44 | 0.08% |
| LAURALYNE BOONE3 | 4353 DAFFODIL WAY LIVERMORE, CA 94551 | AFLAC | $38 | — | $38 | 0.07% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $29 | — | $29 | 0.05% |
| PETER JAMES SARANTIS3 | 5509 SNOWBRUSH DR ROCKLIN, CA 95677 | AFLAC | $20 | — | $20 | 0.03% |
| NICHOLAS E VIGIL3 | 7808 E CYPRESS ST SCOTTSDALE, AZ 85257 | AFLAC | $12 | — | $12 | 0.02% |
| PETER T ARNOLD3 | 9318 LAGOON DR RENO, NV 89506 | AFLAC | $12 | — | $12 | 0.02% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 229 MCKAYS POINT PL WEST SACRAMENTO, CA 95605 | AFLAC | $4 | — | $4 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $4 | — | $4 | 0.01% |
| BARRY A WHITE3 | 1899 WINDING WAY LINCOLN, CA 95648 | AFLAC | $4 | — | $4 | 0.01% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $2 | — | $2 | 0.00% |
| BENEFITSBAY INSURANCE SOLUTION3 | PO BOX 1585 FAIR OAKS, CA 95628 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 15.00% |
| BENEFITSBAY INSURANCE SOLUTION3 Filed as: BENEFITSBAY INSURANCE SOLUTIONS LLC | P.O. BOX 1585 FAIR OAKS, CA 95628 | EYEMED VISION CARE | $4K | — | $4K | 9.17% |
| BENEFITSBAY INSURANCE SOLUTION3 | PO BOX 1585 FAIR OAKS, CA 95628 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 20.00% |
| BENEFITSBAY INSURANCE SOLUTION3 | PO BOX 1585 FAIR OAKS, CA 95628 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 20.00% |
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 | 210 | 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) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WESTERN HEALTH ADVANTAGE | 582 | $1.6M |
| Vision | EYEMED VISION CARE | 543 | $44K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 208 | $186K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 208 | $141K |
| Prescription drug | WESTERN HEALTH ADVANTAGE | 582 | $1.6M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 216 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 582 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.