| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $29K | $0 | $29K | 6.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $39 | $39 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | BLUECROSS BLUESHIELD OF ILLINOIS | $10K | $650 | $10K | 5.27% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $5K | $0 | $5K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $4K | $8K | 11.67% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | AFLAC | $707 | $0 | $707 | 13.26% |
| KEVIN S. SMEDES3 | 4180 WIGGINS COURT RANCHO CORDOVA, CA 95742 | AFLAC | $502 | $5 | $507 | 9.51% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INS. SOLUTIONS, INC. | 1390 BROADWAY, SUITE B-125 PLACERVILLE, CA 95667 | AFLAC | $194 | $49 | $243 | 4.56% |
| ERIC N RAWLINGS3 Filed as: ERIC N. RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $189 | $1 | $190 | 3.56% |
| RONDA MATHEW3 | 2030 13TH STREET, APARTMENT 3 SACRAMENTO, CA 95818 | AFLAC | $131 | $1 | $132 | 2.48% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 5701 LONETREE BOULEVARD, SUITE 111 ROCKLIN, CA 95765 | AFLAC | $91 | $0 | $91 | 1.71% |
| PETER JAMES SARANTIS3 Filed as: PETER JAMES SARANTIS & OTHER AGENTS | 5509 SNOWBRUSH DRIVE ROCKLIN, CA 95677 | AFLAC | $47 | $11 | $58 | 1.09% |
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 | 196 | 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) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 74 | $718K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $73K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $73K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $78K |
| Short-term disability | AFLAC | 8 | $5K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 74 | $718K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.