| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | KAISER FOUNDATION HEALTH PLAN, INC. | $24K | $0 | $24K | 4.03% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | WESTERN HEALTH ADVANTAGE | $15K | $0 | $15K | 5.00% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $1K | $10K | 11.57% |
| CELITA ANN PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $1K | $230 | $1K | 8.41% |
| ASSUREDPARTNERS3 | 1455 RESPONSE ROAD, SUITE 260 SACRAMENTO, CA 95815 | AFLAC | $727 | $0 | $727 | 4.65% |
| MJ INSURANCE3 Filed as: ANDY B. GLENN II AND VARIOUS AGENTS | 2999 DOUGLAS BOULEVARD SUITE 180 ROSEVILLE, CA 95661 | AFLAC | $374 | $54 | $428 | 2.74% |
| RONDA MATHEW3 | 2030 13TH STREET, APARTMENT 3 SACRAMENTO, CA 95818 | AFLAC | $235 | $54 | $289 | 1.85% |
| LAURA RUNYEON3 Filed as: LAURA J. RUNYEON | 2042 WEATHERBY WAY PETALUMA, CA 94954 | AFLAC | $172 | $0 | $172 | 1.10% |
| ERIC N RAWLINGS3 Filed as: ERIC N. RAWLINGS | 9092 POSADA WAY SACRAMENTO, CA 95826 | AFLAC | $130 | $0 | $130 | 0.83% |
| ROSALIE KAY PARKS3 | 136 MARK WEST STATION ROAD WINDSOR, CA 95492 | AFLAC | $115 | $0 | $115 | 0.74% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | PRINCIPAL LIFE INSURANCE COMPANY | $934 | $105 | $1K | 12.22% |
| AP BENEFIT ADVISORS, LLC3 | 10 NORTH PARK DRIVE, SUITE 200 HUNT VALLEY, MD 21030 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $305 | $305 | 3.59% |
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 | 196 | 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) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 89 | $900K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $88K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 121 | $9K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $104K |
| Short-term disability | AFLAC | 15 | $16K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 89 | $606K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.