| 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 | WESTERN HEALTH ADVANTAGE | $59K | $0 | $59K | 2.97% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERVICES INC. | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $8K | $16K | 8.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 5.74% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, STE 400 VALHALLA, NY 10595 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 66119 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $489 | $0 | $489 | 1.65% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $303 | $0 | $303 | 1.02% |
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 | 358 | 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) | 358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WESTERN HEALTH ADVANTAGE | 358 | $2.0M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 231 | $30K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $192K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $192K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $192K |
| Prescription drug | WESTERN HEALTH ADVANTAGE | 358 | $2.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.