| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYHABENEFITS INSURANCE SOLUTIONS3 | LLC PO BOX 1585 FAIR OAKS, CA 95628 | WESTERN HEALTH ADVANTAGE | $17K | — | $17K | 0.54% |
| BENEFITSBAY INSURANCE SOLUTION3 | PO BOX 1585 FAIR OAKS, CA 95628 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.64% |
| CRAIG ALLEN HENRY PFAFF3 Filed as: CRAIG ALLEN PFAFF | 9672 ELMIRA CIR SACRAMENTO, CA 95827 | AFLAC | $4K | $26 | $4K | 8.17% |
| ERIC N RAWLINGS3 Filed as: ERIC RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $878 | — | $878 | 1.61% |
| LEON NORMAN DAVIDSON3 Filed as: LEON DAVIDSON | 1230 ARROYO GRANDE DR SACRAMENTO, CA 95864 | AFLAC | $475 | — | $475 | 0.87% |
| DEBORAH L SENN3 Filed as: DEBORAH SENN | 230 BRIGGS RANCH DR FOLSOM, CA 95630 | AFLAC | $359 | — | $359 | 0.66% |
| DIANA CABRAL RENTCHLER3 Filed as: DIANA RENTCHLER | PO BOX 54 WEST SACRAMENTO, CA 95691 | AFLAC | $279 | — | $279 | 0.51% |
| JACE KUERSTEN3 | 7937 E JOSHUA TREE LN SCOTTSDALE, AZ 85250 | AFLAC | $226 | — | $226 | 0.41% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 5509 SNOWBRUSH DR ROCKLIN, CA 95677 | AFLAC | $226 | — | $226 | 0.41% |
| DAVID B. KITCHEN3 Filed as: DAVID KITCHEN | 5230 HARTER LN LA CANADA FLINTRIDGE, CA 91011 | AFLAC | $159 | — | $159 | 0.29% |
| AIMEE L PFAFF3 Filed as: AIMEE PFAFF | 6601 TRILBY CT CITRUS HEIGHTS, CA 95610 | AFLAC | $129 | — | $129 | 0.24% |
| JAMES S SARANTIS3 | 14132 SE FIRCREST CT PORTLAND, OR 97236 | AFLAC | $85 | — | $85 | 0.16% |
| ROBERT PILKENTON3 | 6643 FM 2187 RD SEALY, TX 77474 | AFLAC | $48 | — | $48 | 0.09% |
| LAURALYNE BOONE3 | 4353 DAFFODIL WAY LIVERMORE, CA 94551 | AFLAC | $46 | — | $46 | 0.08% |
| ANDY B GLENN II3 | 2999 DOUGLAS BLVD SUIE 180 ROSEVILLE, CA 95661 | AFLAC | $32 | — | $32 | 0.06% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $26 | — | $26 | 0.05% |
| VIGILANT GROUP, LLC3 | 7808 E CYPRESS ST SCOTTSDALE, AZ 85257 | AFLAC | $13 | — | $13 | 0.02% |
| PETER T ARNOLD3 Filed as: PETER ARNOLD | 8874 PORTIA DR RENO, NV 89506 | AFLAC | $13 | — | $13 | 0.02% |
| SARAH THAXTON3 | 340 SOARING HAWK LN SACRAMENTO, CA 95833 | AFLAC | $8 | — | $8 | 0.01% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 229 MCKAYS POINT PL WEST SACRAMENTO, CA 95605 | AFLAC | $3 | — | $3 | 0.01% |
| MICHAEL RHODD3 | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $3 | — | $3 | 0.01% |
| BARRY A WHITE3 Filed as: BARRY WHITE | 1899 WINDING WAY LINCOLN, CA 95648 | AFLAC | $3 | — | $3 | 0.01% |
| SIERRA N KIRSHY3 Filed as: SIERRA KIRSHY | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $1 | — | $1 | 0.00% |
| BENEFITSBAY INSURANCE SOLUTION3 | PO BOX 1585 FAIR OAKS, CA 95628 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 13.63% |
| BENEFITSBAY INSURANCE SOLUTION3 | PO BOX 1585 FAIR OAKS, CA 95628 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 20.00% |
| BENEFITSBAY INSURANCE SOLUTION3 Filed as: BENEFITSBAY INSURANCE SOLUTIONS LLC | P.O. BOX 1585 FAIR OAKS, CA 95628 | EYEMED VISION CARE | $4K | — | $4K | 10.95% |
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 | 228 | 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) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WESTERN HEALTH ADVANTAGE | 577 | $3.1M |
| Vision | EYEMED VISION CARE | 570 | $38K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 222 | $199K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 222 | $149K |
| Prescription drug | WESTERN HEALTH ADVANTAGE | 577 | $3.1M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $244K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 577 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.