| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | CALIFORNIA PHYSICIANS SERVICE | $69K | $0 | $69K | 5.20% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $11K | $0 | $11K | 5.36% |
| BETH A. HESTER3 Filed as: BETH HESTER | 1143 CHAMPAGNE LANE MANTECA, CA 95337 | AFLAC | $4K | $158 | $4K | 10.39% |
| BARRY A WHITE3 Filed as: BARRY WHITE AND OTHER AGENTS | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $1K | $20 | $1K | 3.28% |
| SERAPIO M. NAMBO3 Filed as: SERAPIO NAMBO | 2175 57TH AVENUE SACRAMENTO, CA 95822 | AFLAC | $352 | $2 | $354 | 0.97% |
| GUSTAVO ARRIAGA II3 | 1140 MANGROVE AVENUE, SUITE D CHICO, CA 95926 | AFLAC | $296 | $29 | $325 | 0.89% |
| DAVID B. KITCHEN3 Filed as: DAVID KITCHEN | 1260 NORTH DUTTON AVENUE, SUITE 180 SANTA ROSA, CA 95401 | AFLAC | $202 | $0 | $202 | 0.55% |
| GEORGIANNA STOUT3 | 150 HARBOR DRIVE, UNIT 370 SAUSALITO, CA 94966 | AFLAC | $149 | $50 | $199 | 0.55% |
| ANA ARRIAGA3 | 283 MAIN STREET, SUITE 180 WOODLAND, CA 95695 | AFLAC | $156 | $29 | $185 | 0.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNION SECURITY INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 3247 WEST MARCH LANE, SUITE 210 STOCKTON, CA 95219 | VISION SERVICE PLAN | $884 | $0 | $884 | 6.42% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 162 | $1.5M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 162 | $1.3M |
| Vision | VISION SERVICE PLAN | 105 | $14K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 105 | $15K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 30 | $209K |
| Other(2 contracts, 2 carriers) | AFLAC | 105 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.