| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 1.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 0.55% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | WESTERN HEALTH ADVANTAGE | $30K | — | $30K | 7.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF CALIFORNIA | $1K | $0 | $1K | 7.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | DELTA DENTAL OF CALIFORNIA | $601 | — | $601 | 3.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN, INC. | $176 | — | $176 | 0.95% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF CALIFORNIA | $656 | $0 | $656 | 7.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | DELTA DENTAL OF CALIFORNIA | $281 | $0 | $281 | 3.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | GERBER LIFE INSURANCE CO. (MESVISION) | $82 | — | $82 | 4.97% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | GERBER LIFE INSURANCE CO. (MESVISION) | $72 | — | $72 | 5.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | CYPRESS DENTAL ADMINISTRATORS | $8 | $0 | $8 | 9.76% |
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 | 94 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 94 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 68 | $1.1M |
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 40 | $29K |
| Vision(3 contracts, 2 carriers) | GERBER LIFE INSURANCE CO. (MESVISION) | 5 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 68 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.