| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | KAISER FOUNDATION HEALTH PLAN INC | $42K | $0 | $42K | 2.77% |
| SANITAS BENEFITS, INC.3 | 1845 IRON POINT ROAD, SUITE 100 FOLSOM, CA 95630 | KAISER FOUNDATION HEALTH PLAN INC | $18 | $0 | $18 | 0.00% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $1K | $20K | 10.69% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | $0 | $6K | 4.24% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 2251 DOUGLAS BOULEVARD, SUITE 115 ROSEVILLE, CA 95661 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $0 | $1K | 1.13% |
| BILL MARR3 Filed as: BILL LEE MARR | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | UNITEDHEALTHCARE INSURANCE COMPANY | $396 | $0 | $396 | 0.30% |
| ASSUREDPARTNERS3 | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | PRINCIPAL LIFE INSURANCE COMPANY | $988 | $0 | $988 | 7.81% |
| ASSUREDPARTNERS3 | 1455 RESPONSE ROAD, SUITE 260 SACRAMENTO, CA 95815 | HEALTHIEST YOU | $501 | $0 | $501 | 13.68% |
| SANITAS BENEFITS, INC.3 Filed as: SANITAS EMPLOYEE BENEFITS, INC. | 1845 IRON POINT ROAD, SUITE 100 FOLSOM, CA 95630 | HEALTHIEST YOU | $49 | $0 | $49 | 1.34% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 201 | $1.6M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $184K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 222 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $184K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $184K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $184K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 201 | $1.6M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.