| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WRAITH, SCARLETT & RANDOLPH3 Filed as: WRAITH, SCARLETT & RANDOLPH INS. | 509 BUSH STREET WOODLAND, CA 95695 | KAISER FOUNDATION HEALTH PLAN INC | $19K | $0 | $19K | 4.91% |
| WRAITH, SCARLETT & RANDOLPH3 Filed as: WRAITH, SCARLETT & RANDOLPH INS. | 509 BUSH STREET WOODLAND, CA 95695 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.55% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS. | 2677 NORTH MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.00% |
| WRAITH, SCARLETT & RANDOLPH3 Filed as: WRAITH, SCARLETT & RANDOLPH INS. | 509 BUSH STREET WOODLAND, CA 95695 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 7.90% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INS. SOLUTIONS | 1390 BROADWAY, SUITE B125 PLACERVILLE, CA 95667 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.10% |
| WRAITH, SCARLETT & RANDOLPH3 Filed as: WRAITH, SCARLETT & RANDOLPH INS. | 509 BUSH STREET WOODLAND, CA 95695 | VISION SERVICE PLAN | $2K | $0 | $2K | 10.00% |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 67 | $378K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 294 | $176K |
| Vision | VISION SERVICE PLAN | 157 | $24K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 84 | $54K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 84 | $54K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 67 | $378K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 84 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.