| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2270 DOUGLAS BOULEVARD, SUITE 220 ROSEVILLE, CA 95661 | KAISER FOUNDATION HEALTH PLAN, INC. | $38K | $0 | $38K | 3.26% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 8950 CAL CENTER DRIVE, BUILDING 3 SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN, INC. | -$3K | $0 | -$3K | -0.26% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 5401 OLD REDWOOD HIGHWAY, SUITE 105 PETALUMA, CA 94954 | SUTTER HEALTH PLAN | $25K | $0 | $25K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $1K | $14K | 8.80% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 7500 OLD GEORGETOWN ROAD, SUITE 925 BETHESDA, MD 20814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 8.24% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 700 AIRPORT BOULEVARD, SUITE 300 BURLINGAME, CA 94010 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 3.33% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.80% |
| INTERWEST INSURANCE SERVICES, LLC3 | 8950 CAL CENTER DRIVE, SUITE 200 SACRAMENTO, CA 95826 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.76% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 3645 WESTWIND BOULEVARD, SUITE A SANTA ROSA, CA 95403 | CHINESE COMMUNITY HEALTH PLAN | $5K | — | $5K | 5.00% |
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 | 263 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 122 | $1.8M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 219 | $156K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 219 | $156K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $116K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $116K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 122 | $1.8M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.