| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WINTON-IRELAND INSURANCE AGENCY INC3 Filed as: WINTON-IRELAND INSURANCE AGENCY,INC | PO BOX 3277 TURLOCK, CA 953813277 | KAISER FOUNDATION HEALTH PLAN INC | $50K | $0 | $50K | 2.99% |
| WINTON-IRELAND INS AGENCY3 | 687 E CANAL DR TURLOCK, CA 95380 | BLUE SHIELD OF CALIFORNIA | $40K | $0 | $40K | 4.52% |
| WINTON-IRELAND INS AGENCY3 Filed as: WINTON IRELAND INS AGENCY INC | 627 E CANAL DRIVE TURLOCK, CA 95381 | DELTA DENTAL OF CALIFORNIA | $14K | — | $14K | 5.00% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 3171 PINERO COURT SPARKS, NV 89436 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 1.30% |
| WAYNE RIMMER3 Filed as: WAYNE P SMITH | 402 WEST LOCKHART LANE MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $949 | $0 | $949 | 1.18% |
| DOUGLAS HIBL3 | 1620 NORTH CARPENTER RD MODESTO, CA 95351 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $788 | $0 | $788 | 0.98% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $644 | $77 | $721 | 0.89% |
| LISA M KELLEY3 Filed as: LISA M KELLY | 2649 GLEN CT VALLEY SPRINGS, CA 95252 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $619 | $0 | $619 | 0.77% |
| PAMELA KAY LONG3 | 200 S. LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $236 | $18 | $254 | 0.32% |
| CASEY JAMES KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $53 | $87 | 0.11% |
| BRIAN ROBERT LLOYD3 Filed as: BRIAN ROBERT LOYD | PO BOX 11 KNIGHTSEN, CA 94548 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $36 | $70 | 0.09% |
| DEBORAH LYNN WELLS3 | 5809 MARK TWAIN AVENUE SACRAMENTO, CA 95820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | $0 | $56 | 0.07% |
| G SCOTT COOKE3 Filed as: SCOTT ALLEN BEER | 8385 N RAISINA AVE FRESNO, CA 93720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $0 | $46 | 0.06% |
| SCOTT E BOORE3 | 8 STONEHAVEN CT NOVATO, CA 94947 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 0.06% |
| NAOMI R HALL3 | 1930 EAST HAROLD AVE VISALIA, CA 93292 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.03% |
| TONEY CHIMIENTI3 | 3403 E FERNAN HILL RD COEUR DALENE, ID 83814 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.03% |
| DARRYL W VIDOR3 | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.02% |
| ONE SOURCE ADVISORS INC3 Filed as: ONE SOURCE ADVISORS LLC | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.02% |
| WINTON-IRELAND INS AGENCY3 | 687 E CANAL DR TURLOCK, CA 95380 | BLUE SHIELD OF CALIFORNIA | $548 | — | $548 | 5.00% |
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 | 236 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 292 | $2.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 457 | $282K |
| Vision | BLUE SHIELD OF CALIFORNIA | 81 | $877K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 236 | $92K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 76 | $81K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 292 | $2.6M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 236 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 457 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.