| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DRIVE #C SACRAMENTO, CA 95864 | WESTERN HEALTH ADVANTAGE | $25K | $0 | $25K | 4.79% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DRIVE #C SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN INC. | $18K | $0 | $18K | 4.92% |
| LAURALYNE BOONE3 | 664 ARNETT WAY GALT, CA 95632 | AFLAC | $1K | $0 | $1K | 3.19% |
| JAYSON C ROCHA3 Filed as: JAYSON ROCHA | 3279 SOUTHLAND RD WEST SACRAMENTO, CA 95691 | AFLAC | $913 | $274 | $1K | 3.14% |
| DEBORAH L SENN3 Filed as: DEBORAH SENN | 230 BRIGGS RANCH DR FOLSOM, CA 95630 | AFLAC | $294 | $0 | $294 | 0.78% |
| JACE KUERSTEN3 | 1574 SAN FERNANDO DR CORONA, CA 92882 | AFLAC | $199 | $71 | $270 | 0.71% |
| DONNA LOUISE DEVINY | 11148 NOATAK RIVER CT RANCHO CORDOVA, CA 95670 | AFLAC | $218 | $0 | $218 | 0.58% |
| JOSE PEREZ3 | 8695 PERSHING AVE FAIR OAKS, CA 95628 | AFLAC | $113 | $0 | $113 | 0.30% |
| REBECCA STUART-GRISHAM3 | PO BOX 202 GARDEN VALLEY, CA 95633 | AFLAC | $106 | $0 | $106 | 0.28% |
| EVANGELIA PANTIS3 | 4934 COTTAGE WAY CARMICHAEL, CA 95608 | AFLAC | $54 | $0 | $54 | 0.14% |
| LINDA BAILEY3 | 6505 DEADERICK CT ORANGEVALE, CA 95662 | AFLAC | $43 | $0 | $43 | 0.11% |
| TRULY B. PINEDA3 Filed as: TRULY PINEDA | 3665 MOUNT ACADIA BLVD SAN DIEGO, CA 92111 | AFLAC | $42 | $0 | $42 | 0.11% |
| BRIAN PORTER3 | 264 SAN ANTONIO WAY SACRAMENTO, CA 95819 | AFLAC | $32 | $0 | $32 | 0.08% |
| JAMES S SARANTIS3 Filed as: JAMES SARANTIS | 14132 SE FIRCREST CT PORTLAND, OR 97236 | AFLAC | $24 | $0 | $24 | 0.06% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS INC. | 221 MAIN ST UNIT 1462 LOS ALTOS, CA 94023 | AFLAC | $20 | $0 | $20 | 0.05% |
| ANDY B GLENN II3 Filed as: ANDY GLENN II | 2999 DOUGLAS BLVD STE 180 ROSEVILLE, CA 95661 | AFLAC | $17 | $0 | $17 | 0.04% |
| MANA INSURANCE SOLUTIONS INC3 | PO BOX 930 MAKOWAO, HI 96768 | AFLAC | $16 | $0 | $16 | 0.04% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $10 | $0 | $10 | 0.03% |
| MATT SMITH3 | 2373 20TH AVE APT4 SAN FRANCISCO, CA 94116 | AFLAC | $9 | $0 | $9 | 0.02% |
| PETER T ARNOLD3 Filed as: PETER ARNOLD | 12199 SILVER SPRING PL GRASS VALLEY, CA 95949 | AFLAC | $3 | $0 | $3 | 0.01% |
| NICHOLAS VIGIL3 | 7808 E CYPRESS ST SCOTTSDALE, AZ 95257 | AFLAC | $3 | $0 | $3 | 0.01% |
| BARRY A WHITE3 Filed as: BARRY WHITE | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $2 | $0 | $2 | 0.01% |
| ROBERT PILKENTON3 | 6643 FM 2187 RD SEALY, TX 77474 | AFLAC | $2 | $0 | $2 | 0.01% |
| LISA A PERRI3 Filed as: LISA HUTCHERSON | 5690 LILYVIEW WAY ELK GROVE, CA 95757 | AFLAC | $2 | $0 | $2 | 0.01% |
| SIERRA N KIRSHY3 Filed as: SIERRA KIRSHY | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $1 | $0 | $1 | 0.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DRIVE #C SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DRIVE #C SACRAMENTO, CA 95864 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DRIVE #C SACRAMENTO, CA 95864 | DIRECT DENTAL ADMINISTRATORS, LLC | $4K | $0 | $4K | 18.88% |
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 | 195 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 173 | $873K |
| Dental | DIRECT DENTAL ADMINISTRATORS, LLC | 195 | $19K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 127 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 69 | $32K |
| Short-term disability | AFLAC | 14 | $38K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 173 | $873K |
| Other(2 contracts, 2 carriers) | AFLAC | 69 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.