| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $16K | $0 | $16K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET SAN FRANCISCO, CA 94105 | WESTERN HEALTH ADVANTAGE | $6K | $0 | $6K | 1.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PREMIER ACCESS INSURANCE COMPANY | $3K | $0 | $3K | 5.09% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $276 | $5K | 12.57% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $35 | $0 | $35 | 0.09% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $869 | $91 | $960 | 6.42% |
| UNKNOWN3 | UNKNOWN SACRAMENTO, CA 95841 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $82 | $0 | $82 | 0.55% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 EAST 1ST STREET, SUITE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.17% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.15% |
| USI INSURANCE SERVICES LLC3 | 1039-A NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | GERBER | $1K | $0 | $1K | 10.00% |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 37 | $615K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 141 | $51K |
| Vision | GERBER | 123 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $55K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 52 | $15K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $40K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 37 | $615K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.