| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WARREN G BENDER CO3 Filed as: WARREN G. BENDER COMPANY | 516 GIBSON DRIVE, SUITE 240 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC | $37K | $0 | $37K | 5.34% |
| BENDER INSURANCE SOLUTIONS3 | 516 GIBSON DRIVE, SUITE 240 ROSEVILLE, CA 95678 | SUTTER HEALTH PLAN | $10K | $0 | $10K | 4.95% |
| BENDER INSURANCE SOLUTIONS3 | 516 GIBSON DRIVE, SUITE 240 ROSEVILLE, CA 95678 | KANSAS CITY LIFE INSURANCE COMPANY | $9K | $0 | $9K | 10.59% |
| WARREN G BENDER CO3 Filed as: WARREN G. BENDER COMPANY | 516 GIBSON DRIVE, SUITE 240 ROSEVILLE, CA 95678 | VISION SERVICE PLAN | $784 | $0 | $784 | 7.13% |
| CELITA ANN PEDRO3 | 6705 MIRAVISTA DRIVE ROCKLIN, CA 95677 | AFLAC | $612 | $43 | $655 | 8.50% |
| WARREN G BENDER CO3 Filed as: WARREN G. BENDER COMPANY | PO BOX 1932 LINCOLN, CA 95648 | AFLAC | $303 | $0 | $303 | 3.93% |
| MJ INSURANCE3 Filed as: ANDY B. GLENN AND VARIOUS AGENTS | 2281 LAVA RIDGE COURT, SUITE 130 ROSEVILLE, CA 95661 | AFLAC | $200 | $0 | $200 | 2.59% |
| RUMBAUGH ONE INSURANCE SOLUTIONS3 Filed as: RUMBAUGH ONE INS. SOLUTIONS INC. | 1079 SUNRISE AVENUE, SUITE B305 ROSEVILLE, CA 95661 | AFLAC | $150 | $0 | $150 | 1.95% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $119 | $9 | $128 | 1.66% |
| JACE G KUERSTEN3 Filed as: JACE G. KUERSTEN | 1574 SAN FERNANDO DRIVE CORONA, CA 92882 | AFLAC | $115 | $9 | $124 | 1.61% |
| DAVID HUGH WALLACE3 | 1225 FITCH WAY SACRAMENTO, CA 95864 | AFLAC | $98 | $0 | $98 | 1.27% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: BENEFIT & RISK MANAGEMENT SERVICES | 80 IRON POINT CIRCLE, SUITE 200 FOLSOM, CA 95630 | HEALTHIEST YOU | $183 | $0 | $183 | 25.00% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 115 | $881K |
| Dental | KANSAS CITY LIFE INSURANCE COMPANY | 112 | $83K |
| Vision | VISION SERVICE PLAN | 81 | $11K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 112 | $83K |
| Short-term disability | AFLAC | 9 | $8K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 115 | $881K |
| Other(3 contracts, 3 carriers) | KANSAS CITY LIFE INSURANCE COMPANY | 112 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.