| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | WESTERN HEALTH ADVANTAGE | $22K | $0 | $22K | 3.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | CYPRESS DENTAL ADMINISTRATORS | $2K | $0 | $2K | 2.08% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | CYPRESS DENTAL ADMINISTRATORS | $2K | $0 | $2K | 1.86% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.33% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 6.48% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.92% |
| AMES-GRENZ INSURANCE SERVICES, INC.5 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $718 | $718 | 1.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.50% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.28% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.64% |
| AMES-GRENZ INSURANCE SERVICES, INC.5 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $725 | $725 | 3.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.79% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $929 | $929 | 5.18% |
| AMES-GRENZ INSURANCE SERVICES, INC.5 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $730 | $730 | 4.07% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $75 | $0 | $75 | 0.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WEST | 100 SUMMIT LAKE DR STE 400 VALHALLA, NY 10595 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $241 | $0 | $241 | 1.87% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $237 | $0 | $237 | 1.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $237 | $0 | $237 | 5.72% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $208 | $208 | 5.02% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES-GRENZ INSURANCE SERV INC | 3435 AMERICAN RIVER DR STE 3435 SACRAMENTO, CA 95864 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $177 | $0 | $177 | 4.27% |
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 | 300 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CYPRESS DENTAL ADMINISTRATORS | 184 | $100K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 125 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 65 | $20K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 243 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.