| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERVICES INC. | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | WESTERN HEALTH ADVANTAGE | $17K | $0 | $17K | 4.60% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERVICES INC. | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 7.79% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.88% |
| LAURALYNE BOONE3 | 4353 DAFFODIL WAY LIVERMORE, CA 94551 | AFLAC | $914 | $0 | $914 | 2.68% |
| DEBORAH L SENN3 | 230 BRIGGS RANCH DR FOLSOM, CA 95630 | AFLAC | $693 | $0 | $693 | 2.03% |
| JAYSON C ROCHA3 | 3577 SAINT JOHN RD WEST SACRAMENTO, CA 95691 | AFLAC | $572 | $0 | $572 | 1.68% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK RD FL 2 RANCHO CORDOVA, CA 95670 | AFLAC | $445 | $0 | $445 | 1.31% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INS SVCS INC | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | AFLAC | $326 | $0 | $326 | 0.96% |
| ERIC N RAWLINGS3 | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $295 | $0 | $295 | 0.87% |
| KEVIN S. SMEDES3 Filed as: KEVIN S SMEDES | 1149 WATT AVE SACRAMENTO, CA 95661 | AFLAC | $256 | $0 | $256 | 0.75% |
| ANDY B GLENN II3 | 2999 DOUGLAS BLVD SUIE 180 ROSEVILLE, CA 95661 | AFLAC | $209 | $0 | $209 | 0.61% |
| JACE G KUERSTEN3 | 1574 SAN FERNANDO DR CORONA, CA 92882 | AFLAC | $140 | $0 | $140 | 0.41% |
| DONNA LOUISE DEVINY3 | 11148 NOATAK RIVER CT RANCHO CORDOVA, CA 95670 | AFLAC | $116 | $0 | $116 | 0.34% |
| JOSE PEREZ3 | 8695 PERSHING AVE FAIR OAKS, CA 95628 | AFLAC | $105 | $0 | $105 | 0.31% |
| REBECCA STUART-GRISHAM3 Filed as: REBECCA A STUART-GRISHAM | PO BOX 202 GARDEN VALLEY, CA 95633 | AFLAC | $95 | $0 | $95 | 0.28% |
| BRIAN PORTER3 Filed as: BRIAN ROBERT PORTER | 264 SAN ANTONIO WAY SACRAMENTO, CA 95819 | AFLAC | $89 | $0 | $89 | 0.26% |
| EVANGELIA PANTIS3 | 4934 COTTAGE WAY CARMICHAEL, CA 95608 | AFLAC | $50 | $0 | $50 | 0.15% |
| SANDRA S. BELSTLER3 Filed as: SANDRA S BELSTLER | PO BOX 4892 EL DORADO HILLS, CA 95762 | AFLAC | $28 | $0 | $28 | 0.08% |
| LINDA BAILEY3 Filed as: LINDA G BAILEY | 6505 DEADERICK CT ORANGEVALE, CA 95662 | AFLAC | $25 | $0 | $25 | 0.07% |
| JAMES S SARANTIS3 | 14132 SE FIRCREST CT PORTLAND, OR 97236 | AFLAC | $22 | $0 | $22 | 0.06% |
| LINDA BAILEY3 | 6505 DEADERICK CT ORANGEVALE, CA 95662 | AFLAC | $13 | $0 | $13 | 0.04% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $9 | $0 | $9 | 0.03% |
| PETER T ARNOLD3 | 9318 LAGOON DR RENO, NV 89506 | AFLAC | $3 | $0 | $3 | 0.01% |
| NICHOLAS E VIGIL3 | 7808 E CYPRESS ST SCOTTSDALE, AZ 85257 | AFLAC | $3 | $0 | $3 | 0.01% |
| BARRY A WHITE3 | 1899 WINDING WAY LINCOLN, CA 95648 | AFLAC | $2 | $0 | $2 | 0.01% |
| ROBERT PILKENTON3 Filed as: ROBERT L PILKENTON | 6643 FM 2187 RD SEALY, TX 77474 | AFLAC | $2 | $0 | $2 | 0.01% |
| LISA M HUTCHERSON3 | 5690 LILYVIEW WAY ELK GROVE, CA 95757 | AFLAC | $2 | $0 | $2 | 0.01% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $1 | $0 | $1 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, STE 400 VALHALLA, NY 10595 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $845 | $0 | $845 | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 66119 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $208 | $0 | $208 | 0.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $105 | $0 | $105 | 0.50% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERVICES INC. | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | — |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $9K | $0 | $9K | — |
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 | 201 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 169 | $369K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 134 | $21K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $73K |
| Short-term disability | AFLAC | 39 | $34K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 169 | $369K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.