| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 | PO BOX 8110 CHICO, CA 95927 | METROPOLITAN LIFE INSURANCE COMPANY | $29K | $0 | $29K | 7.32% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 5401 OLD REDWOOD HIGHWAY, SUITE 105 PETALUMA, CA 94954 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 0.69% |
| INTERWEST INSURANCE SERVICES, LLC3 | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $31K | $9K | $40K | 16.09% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 2.77% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 700 AIRPORT BOULEVARD, SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 2.63% |
| SAHAR QABAZARD3 | 18121 CALIFORNIA COURT SONOMA, CA 95476 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | $0 | $8 | 6.30% |
| SHANE EDMUND ATTEBERY3 Filed as: SHANE E. ATTEBERY | 2824 SOUTH RIVER ROAD GRANTS PASS, OR 97527 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.79% |
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 | 517 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 475 | $3.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $395K |
| Vision | VISION SERVICE PLAN | 357 | $42K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 513 | $247K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 517 | $127 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 513 | $247K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 475 | $3.0M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 517 | $260K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 944 | — |
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."
No prospect flags tripped on this filing.