| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $60K | $0 | $60K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 1.86% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA INSURANCE COMPANY | $7K | $0 | $7K | 9.95% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | $0 | $7K | 10.83% |
| DARRYL W VIDOR3 Filed as: DARRYL W. VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $46 | $2K | 11.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1 | $2K | 8.08% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $325 | $32 | $357 | 1.61% |
| BARBARA GARLAND3 Filed as: BARBARA GAYLE GARLAND | 1510 YELLOWSTONE COURT ROCKLIN, CA 95765 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $75 | $0 | $75 | 0.34% |
| ONE SOURCE ADVISORS INC3 Filed as: ONE SOURCE ADVISORS LLC | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $0 | $57 | 0.26% |
| MARY KOCH3 | 117 WOLF RIVER COURT ROSEVILLE, CA 95661 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.20% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN ROCKLIN, CA 95765 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| DIVERSIFIED INSURANCE GROUP3 | UNKNOWN ROCKLIN, CA 95765 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $80 | $0 | $80 | 0.40% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | $0 | $2K | 10.14% |
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 | 239 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 273 | $1.9M |
| Dental(3 contracts, 3 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 150 | $111K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 110 | $20K |
| Life insurance(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 239 | $89K |
| Short-term disability(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 239 | $89K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 239 | $67K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 273 | $1.9M |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 239 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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."
No prospect flags tripped on this filing.