| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 2421 WEST PEORIA AVENUE PHOENIX, AZ 85029 | WESTERN HEALTH ADVANTAGE | $26K | $0 | $26K | 4.62% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | $0 | $16K | 4.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | $0 | $5K | 1.23% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 17.84% |
| BRI PARENT, INC.5 | 246 KENNETH DRIVE ROCHESTER, NY 14623 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 13.98% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 12.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $988 | $0 | $988 | 5.12% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $632 | $0 | $632 | 3.65% |
| DONNA LOUISE DEVINY3 Filed as: DONNA L. DEVINY AND OTHER AGENTS | 11148 NOATAK RIVER COURT RANCHO CORDOVA, CA 95670 | AFLAC | $605 | $0 | $605 | 3.50% |
| JAYSON C ROCHA3 Filed as: JAYSON C. ROCHA | 3577 SAINT JOHN ROAD WEST SACRAMENTO, CA 95691 | AFLAC | $573 | $0 | $573 | 3.31% |
| KEVIN S. SMEDES3 | 1149 WATT AVENUE SACRAMENTO, CA 95864 | AFLAC | $526 | $0 | $526 | 3.04% |
| ERIC N RAWLINGS3 Filed as: ERIC N. RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $263 | $0 | $263 | 1.52% |
| LAURALYNE BOONE3 | 4353 DAFFODIL WAY LIVERMORE, CA 94551 | AFLAC | $209 | $0 | $209 | 1.21% |
| ANDY B GLENN II3 Filed as: ANDY B. GLENN II | 2999 DOUGLAS BOULEVARD, SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $150 | $0 | $150 | 0.87% |
| UNKNOWN3 | UNKNOWN ELK GROVE, CA 95757 | DIRECT DENTAL ADMINISTRATORS, LLC | $3K | $0 | $3K | 20.53% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $495 | $0 | $495 | 5.73% |
| ANDY B GLENN II3 Filed as: ANDY B. GLENN II AND OTHER AGENTS | 2999 DOUGLAS BOULEVARD, SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $425 | $0 | $425 | 4.92% |
| DEBORAH L SENN3 Filed as: DEBORAH L. SENN | 230 BRIGGS RANCH DRIVE FOLSOM, CA 95630 | AFLAC | $338 | $0 | $338 | 3.91% |
| ERIC N RAWLINGS3 Filed as: ERIC N. RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $209 | $0 | $209 | 2.42% |
| SANDRA S. BELSTLER3 | PO BOX 4892 EL DORADO HILLS, CA 95762 | AFLAC | $156 | $0 | $156 | 1.80% |
| KEVIN S. SMEDES3 | 1149 WATT AVENUE SACRAMENTO, CA 95864 | AFLAC | $138 | $0 | $138 | 1.60% |
| KAREN ANDREA LENETT3 | 2641 PIPESTONE LOOP ROSEVILLE, CA 95747 | AFLAC | $105 | $0 | $105 | 1.21% |
| LAURALYNE BOONE3 | 4353 DAFFODIL WAY LIVERMORE, CA 94551 | AFLAC | $67 | $0 | $67 | 1.67% |
| JAYSON C ROCHA3 Filed as: JAYSON C. ROCHA | 3577 SAINT JOHN ROAD WEST SACRAMENTO, CA 95691 | AFLAC | $61 | $0 | $61 | 1.52% |
| KEVIN S. SMEDES3 | 1149 WATT AVENUE SACRAMENTO, CA 95864 | AFLAC | $40 | $0 | $40 | 1.00% |
| DEBORAH L SENN3 Filed as: DEBORAH L. SENN | 230 BRIGGS RANCH DRIVE FOLSOM, CA 95630 | AFLAC | $33 | $0 | $33 | 0.82% |
| JACE G KUERSTEN3 Filed as: JACE G. KUERSTEN | 1574 SAN FERNANDO DRIVE CORONA, CA 92882 | AFLAC | $19 | $0 | $19 | 0.47% |
| ERIC N RAWLINGS3 Filed as: ERIC N. RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $11 | $0 | $11 | 0.27% |
| ANDY B GLENN II3 Filed as: ANDY B. GLENN II | 2999 DOUGLAS BOULEVARD, SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $7 | $0 | $7 | 0.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $266 | $0 | $266 | 9.99% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $117 | $0 | $117 | 13.18% |
| JAYSON C ROCHA3 Filed as: JAYSON C. ROCHA | 3577 SAINT JOHN ROAD WEST SACRAMENTO, CA 95691 | AFLAC | $73 | $0 | $73 | 8.22% |
| DEBORAH L SENN3 Filed as: DEBORAH L. SENN | 230 BRIGGS RANCH DRIVE FOLSOM, CA 95630 | AFLAC | $49 | $0 | $49 | 5.52% |
| ERIC N RAWLINGS3 Filed as: ERIC N. RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $28 | $0 | $28 | 3.15% |
| KEVIN S. SMEDES3 | 1149 WATT AVENUE SACRAMENTO, CA 95864 | AFLAC | $21 | $0 | $21 | 2.36% |
| ANDY B GLENN II3 Filed as: ANDY B. GLENN II | 2999 DOUGLAS BOULEVARD, SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $20 | $0 | $20 | 2.25% |
| JACE G KUERSTEN3 Filed as: JACE G. KUERSTEN | 1574 SAN FERNANDO DRIVE CORONA, CA 92882 | AFLAC | $5 | $0 | $5 | 0.56% |
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. |
| 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) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 146 | $947K |
| Dental | DIRECT DENTAL ADMINISTRATORS, LLC | 177 | $17K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 219 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 257 | $44K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $46K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 146 | $947K |
| Other(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 257 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.