| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 5401 OLD REDWOOD HIGHWAY, SUITE 105 PETALUMA, CA 94954 | METROPOLITAN LIFE INSURANCE COMPANY | $31K | $0 | $31K | 8.02% |
| INTERWEST INSURANCE SERVICES, LLC3 | PO BOX 8110 CHICO, CA 95927 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 1.28% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 7500 OLD GEORGETOWN ROAD, SUITE 925 BETHESDA, MD 20814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $36K | $0 | $36K | 14.99% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 700 AIRPORT BOULEVARD, SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $12K | $12K | 5.02% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 3.87% |
| MJ INSURANCE3 Filed as: SHANE E ATTEBERY AND VARIOUS AGENTS | 391 RANDY DRIVE GRANTS PASS, OR 97527 | AFLAC | $141 | $0 | $141 | 2.22% |
| SAHAR QABAZARD3 | 443 SOUTH MAPLE DRIVE BEVERLY HILLS, CA 90212 | AFLAC | $124 | $0 | $124 | 1.95% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY ROAD FAIRFIELD, CA 94534 | AFLAC | $95 | $0 | $95 | 1.50% |
| TIMOTHY FRANCIS RANUIO3 | 4420 SPRINGWOOD DRIVE NAPA, CA 94558 | AFLAC | $93 | $0 | $93 | 1.46% |
| KEN P. MCGRATH3 | 73-4863 ANINI STREET KAILUA KONA, HI 96740 | AFLAC | $84 | $0 | $84 | 1.32% |
| ERIN L. RIGGINS3 | 9504 SHEFFIELD STREET WINDSOR, CA 95492 | AFLAC | $44 | $0 | $44 | 0.69% |
| BENJAMIN R. WERTHIMER3 | 6398 SAN SIMEON DRIVE ROHNERT PARK, CA 94928 | AFLAC | $38 | $0 | $38 | 0.60% |
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 | 500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 317 | $3.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 881 | $385K |
| Vision | VISION SERVICE PLAN | 353 | $41K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 500 | $240K |
| Short-term disability | AFLAC | 4 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 500 | $240K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 317 | $3.2M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 514 | $262K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 881 | — |
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.