| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | KAISER FOUNDATION HEALTH PLAN, INC. | $26K | $0 | $26K | 4.06% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | WESTERN HEALTH ADVANTAGE | $19K | $0 | $19K | 4.97% |
| ASSUREDPARTNERS3 | 1300 DOVE STREET, SUITE 300 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $3K | $13K | 13.87% |
| ARACELIA PEDRO3 Filed as: ARACELIA ANN PEDRO | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $465 | $90 | $555 | 3.66% |
| MICHAEL BOOTH3 Filed as: MICHAEL H. BOOTH AND OTHER AGENTS | 5325 ALHAMBRA VALLEY ROAD MARTINEZ, CA 94553 | AFLAC | $284 | $18 | $302 | 1.99% |
| ASSUREDPARTNERS3 | 1455 RESPONSE ROAD, SUITE 260 SACRAMENTO, CA 95815 | AFLAC | $229 | $0 | $229 | 1.51% |
| LAURA RUNYEON3 Filed as: LAURA J. RUNYEON | 2042 WEATHERBY WAY PETALUMA, CA 94954 | AFLAC | $187 | $0 | $187 | 1.23% |
| RONDA MATHEW3 | 2030 13TH STREET, APRTMENT 3 SACRAMENTO, CA 95818 | AFLAC | $162 | $18 | $180 | 1.19% |
| ROSALIE KAY PARKS3 | 136 MARK WEST STATION ROAD WINDSOR, CA 95492 | AFLAC | $115 | $0 | $115 | 0.76% |
| ANDY B GLENN II3 Filed as: ANDY B. GLENN II | 2999 DOUGLAS BOULEVARD, SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $96 | $0 | $96 | 0.63% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | PRINCIPAL LIFE INSURANCE COMPANY | $982 | $49 | $1K | 10.48% |
| AP BENEFIT ADVISORS, LLC3 | 10 NORTH PARK DRIVE, SUITE 200 HUNT VALLEY, MD 21030 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $46 | $46 | 0.47% |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 92 | $1.0M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $90K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 130 | $10K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $106K |
| Short-term disability | AFLAC | 13 | $15K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 92 | $1.0M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.