| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYERS SELECT INSURANCE SERVICES3 Filed as: EMPLOYERS SELECT INS. SVCS., INC. | 5701 LONGTREE BOULEVARD SUITE 111 ROCKLIN, CA 95765 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $0 | $16K | 2.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $0 | $10K | 1.98% |
| ESIS3 | 5701 LONGTREE BOULEVARD SUITE 305 ROCKLIN, CA 95765 | SUTTER HEALTH PLAN | $11K | $0 | $11K | 2.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 255387 SACRAMENTO, CA 95865 | SUTTER HEALTH PLAN | $9K | $0 | $9K | 1.78% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BOULEVARD SUITE 305 ROCKLIN, CA 95765 | WESTERN HEALTH ADVANTAGE | $9K | $0 | $9K | 4.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 701 UNIVERSITY AVENUE SUITE 100 SACRAMENTO, CA 95825 | WESTERN HEALTH ADVANTAGE | $5K | $0 | $5K | 2.66% |
| EMPLOYERS SELECT INSURANCE SERVICES3 Filed as: EMPLOYERS SELECT INS. SVCS., INC. | 5701 LONGTREE BOULEVARD SUITE 503 ROCKLIN, CA 95765 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 5.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 2.97% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INS SOLUTIONS INC | 1390 BROADWAY SUITE B-125 PLACERVILLE, CA 95667 | AFLAC | $2K | $57 | $3K | 4.01% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BOULEVARD SUITE 111 ROCKLIN, VA 95765 | AFLAC | $2K | $0 | $2K | 2.98% |
| MJ INSURANCE3 Filed as: DEBORAH TURPIN AND VARIOUS AGENTS | 316 NORTH LEXINGTON DRIVE FOLSOM, CA 95630 | AFLAC | $2K | $54 | $2K | 2.82% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: MATTHEW BROWN | PO BOX 7631 CHICO, CA 95927 | AFLAC | $617 | $0 | $617 | 0.98% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 7775 DUTRA BEND DRIVE SACRAMENTO, CA 95831 | AFLAC | $497 | $0 | $497 | 0.79% |
| BRIAN LOWENTHAL3 | 11274 TIMBER COURT AUBURN, CA 95602 | AFLAC | $429 | $0 | $429 | 0.68% |
| JEANNETTE E FATHERREE3 Filed as: JEANNETTE DURRANI | 14835 NORTH 1ST AVENUE PHOENIX, AZ 85023 | AFLAC | $370 | $0 | $370 | 0.59% |
| CHERYL A. COBBIN4 | 2931 TILDEN DRIVE ROSEVILLE, CA 95661 | LEGAL SHIELD | $139 | $0 | $139 | 15.85% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 94 | $1.2M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $159K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $159K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $159K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 94 | $1.2M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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.