| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | PO BOX 8110 CHICO, CA 95927 | METROPOLITAN LIFE INSURANCE COMPANY | $29K | $0 | $29K | 7.97% |
| NONSTOP ADMINISTRATION & INSURANCE3 Filed as: NONSTOP ADMINISTRATION AND INS SVCS | 1800 SUTTER STREET, SUITE 730 CONCORD, CA 94520 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 1.24% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $34K | $8K | $42K | 18.46% |
| FMLASOURCE INC5 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 2.99% |
| SAHAR QABAZARD3 | 18121 CALIFORNIA COURT SONOMA, CA 95476 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25 | $0 | $25 | 6.05% |
| SHANE EDMUND ATTEBERY3 Filed as: SHANE ATTEBERY | 2824 SOUTH RIVER ROAD GRANTS PASS, OR 97527 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | $0 | $5 | 1.21% |
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 | 506 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 23 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 532 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 282 | $2.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 869 | $363K |
| Vision | VISION SERVICE PLAN | 349 | $40K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 507 | $229K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 1 | $413 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 507 | $229K |
| Prescription drug(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 282 | $2.6M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 507 | $241K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 869 | — |
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.