| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CALIFORNIA BANKERS INS./BANKER BEN.3 | 1303 J STREET SACRAMENTO, CA 95814 | STANDARD INSURANCE CO. | $11K | — | $11K | 8.00% |
| CALIFORNIA BANKERS INS./BANKER BEN.3 Filed as: CALIFORNIA BANKERS INS. SVCS | 1303 J STREET SACRAMENTO, CA 95814 | STANDARD INSURANCE CO. | $9K | — | $9K | 8.00% |
| ACSIA PARTNERS LLC3 | 5110 CARILLON POINT KIRKLAND, WA 98033 | LIFESECURE | $1K | — | $1K | 1.94% |
| CALIFORNIA BANKERS INS./BANKER BEN.3 Filed as: CALIFORNIA BANKERS INSURANCE | 1303 J STREET 600 SACRAMENTO, CA 95814 | STANDARD INSURANCE CO. | $5K | — | $5K | 7.94% |
| ACSIA PARTNERS LLC3 | 5110 CARILLON POINT KIRKLAND, WA 98033 | LIFESECURE | $7K | — | $7K | 11.91% |
| CALIFORNIA BANKERS INS./BANKER BEN.3 Filed as: CALIFORNIA BANKERS INS/BANKER BEN. | 1303 J STREET SUITE 600 SACRAMENTO, CA 95814 | STANDARD INSURANCE CO. | $6K | — | $6K | 14.00% |
| CALIFORNIA BANKERS INS./BANKER BEN.3 Filed as: CALIFORNIA BANKERS INSURANCE | 1303 J STREET 600 SACRAMENTO, CA 95814 | STANDARD INSURANCE CO. | $3K | — | $3K | 14.00% |
| ACSIA PARTNERS LLC3 | 5110 CARILLON POINT KIRKLAND, WA 98033 | LIFESECURE | $4K | — | $4K | 26.79% |
| CALIFORNIA BANKERS INS./BANKER BEN.3 Filed as: CALIFORNIA BANKERS INSURANCE | 1303 J STREET 600 SACRAMENTO, CA 95814 | STANDARD INSURANCE CO. | $2K | — | $2K | 14.00% |
| CALIFORNIA BANKERS INS./BANKER BEN.3 Filed as: CALIFORNIA BANKERS INSURANCE | 1303 J STREET 600 SACRAMENTO, CA 95814 | STANDARD INSURANCE CO. | $535 | — | $535 | 9.99% |
| ACSIA PARTNERS LLC3 | 5110 CARILLON POINT KIRKLAND, WA 98033 | LIFESECURE | $21 | — | $21 | 0.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CBIS BANKER BENEFITS EIN 94-3091487 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1303 J STREET SUITE 600 SACRAMENTO, CA 95814 | $71K |
| WALT SUNDERMAN EIN 94-6008616 ADMINISTRATOR | Plan Administrator Service code 14 | 311 PARKER STREET VACAVILLE, CA 95688 | $24K |
| COMYNS,SMITH,MCCLEARY & DEAVER, LLP EIN 68-0307221 ACCOUNTANT | Accounting (including auditing) Service code 10 | 3470 MT DIABLO BOULEVARD SUITE A110 LAFAYETTE, CA 94549 | $21K |
| US BANK EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 555 SW OAK STREET PORTLAND, OR 97204 | $19K |
| TRUCKER HUSS EIN 94-3216063 LEGAL | Legal Service code 29 | ONE EMBARCADERO CENTER SAN FRANCISCO, CA 94111 | $17K |
| INDEPENDENT BANKERS INSURANCE SERVI EIN 16-1654531 INSURANCE | Insurance services Service code 23 | 2520 E UNIVERSITY DR SUITE 103 TEMPE, AZ 85281 | $9K |
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 | 491 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts) | STANDARD INSURANCE CO. | 112 | $311K |
| Vision | STANDARD INSURANCE CO. | 27 | $5K |
| Life insurance | STANDARD INSURANCE CO. | 98 | $45K |
| Short-term disability | STANDARD INSURANCE CO. | 57 | $12K |
| Long-term disability | STANDARD INSURANCE CO. | 98 | $20K |
| Other(6 contracts, 2 carriers) | LIFESECURE | 105 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 112 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.