| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN, INC. | $20K | $0 | $20K | 3.89% |
| INTERWEST INSURANCE SERVICES, LLC3 | PO BOX 8110 CHICO, CA 95927 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 3.37% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 5401 OLD REDWOOD HIGHWAY, SUITE 105 PETALUMA, CA 94954 | METROPOLITAN LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| SAMA HERSHEY DAVIS3 | 3645 WESTWIND BOULEVARD, SUITE A SANTA ROSA, CA 95403 | WESTERN HEALTH ADVANTAGE | $6K | $0 | $6K | 5.00% |
| INTERWEST INSURANCE SERVICES, LLC3 | PO BOX 255188 SACRAMENTO, CA 95865 | HEALTHIEST YOU | $4K | $0 | $4K | 12.56% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, SUITE 2 BOSTON, MA 02110 | HEALTHIEST YOU | $761 | $0 | $761 | 2.44% |
| INTERWEST INSURANCE SERVICES, LLC3 | 1357 A EAST LASSEN AVENUE CHICO, CA 95926 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $495 | $3K | 11.33% |
| INTERWEST INSURANCE SERVICES, LLC3 | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | $0 | $1K | 8.50% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | SUN LIFE ASSURANCE COMPANY OF CANADA | $113 | $0 | $113 | 0.67% |
| INTERWEST INSURANCE SERVICES, LLC3 | UNKNOWN NAPA, CA 94558 | CLAREMONT BEHAVIORAL SERVICES, INC. | $476 | $0 | $476 | 5.00% |
| INTERWEST INSURANCE SERVICES, LLC3 | PO BOX 255188 SACRAMENTO, CA 95865 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $740 | $0 | $740 | 8.40% |
| STEPHANIE NOELLE KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $0 | $113 | 1.28% |
| CASEY JAMES KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.48% |
| BRIAN ROBERT LLOYD3 | 5187 BRENTFORD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.48% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $0 | $36 | 0.41% |
| PAMELA KAY LONG3 | 200 SOUTH LEXINGTON DRIVE APARTMENT 615 FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 0.30% |
| BRITTANY LLOYD3 | 6234 KINGS PEAK DRIVE EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.16% |
| INTERWEST INSURANCE SERVICES, LLC3 | PO BOX 255188 SACRAMENTO, CA 95865 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $153 | $0 | $153 | 8.65% |
| STEPHANIE NOELLE KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 1.13% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.85% |
| CASEY JAMES KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.45% |
| BRIAN ROBERT LLOYD3 | 5187 BRENTFORD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.45% |
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 | 202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 62 | $620K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $122K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $122K |
| Life insurance(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 211 | $28K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 182 | $37K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 62 | $620K |
| Other(6 contracts, 5 carriers) | HEALTHIEST YOU | 238 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.