| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $84K | — | $84K | 5.45% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | UNITEDHEALTHCARE INSURANCE COMPANY | $38K | — | $38K | 2.50% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | GUARDIAN | $25K | $3K | $28K | 11.30% |
| JUDI JONES3 Filed as: JUDI P JONES | 4583 HARMONY PL ROHNERT PARK, CA 94928 | AFLAC | $552 | — | $552 | 4.75% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES DONALD SPROUSE | 13122 MESA CREST PL SAN DIEGO, CA 92129 | AFLAC | $183 | — | $183 | 1.58% |
| MARK C. HUBER3 Filed as: MARK C HUBER | 1100 COLD SPRINGS RD PLACERVILLE, CA 95667 | AFLAC | $168 | — | $168 | 1.45% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DR SANTA ROSA, CA 95403 | AFLAC | $109 | — | $109 | 0.94% |
| MICHAEL BOOTH3 Filed as: MICHAEL H BOOTH | 5325 ALHAMBRA VALLEY RD MARTINEZ, CA 94553 | AFLAC | $51 | — | $51 | 0.44% |
| DAVID B. KITCHEN3 Filed as: DAVID B KITCHEN | 5230 HARTER LN LA CANADA FLINTRIDGE, CA 91011 | AFLAC | $44 | — | $44 | 0.38% |
| KAREN B PETERSON3 | 2735 LAKEVIEW DR SANTA ROSA, CA 95405 | AFLAC | $34 | — | $34 | 0.29% |
| JAYDA M ZEMANSKY3 | 1132 LAKEVILLE CIR PETALUMA, CA 94954 | AFLAC | $32 | — | $32 | 0.28% |
| KEN P. MCGRATH3 Filed as: KEN P MCGRATH | 73-4863 ANINI ST KAILUA KONA, HI 96740 | AFLAC | $32 | — | $32 | 0.28% |
| ROBERT JAMES DUMAS3 | 17 WINDING WAY RANDOLPH, NJ 07869 | AFLAC | $24 | — | $24 | 0.21% |
| TALLY RHOADES3 Filed as: TALLY L RHOADES | 46 GLEN ROYAL DR PUEBLO, CO 81005 | AFLAC | $19 | — | $19 | 0.16% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $17 | — | $17 | 0.15% |
| NICHOLAS E VIGIL3 | 7808 E CYPRESS ST SCOTTSDALE, AZ 85257 | AFLAC | $4 | — | $4 | 0.03% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 229 MCKAYS POINT PL WEST SACRAMENTO, CA 95605 | AFLAC | $3 | — | $3 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $3 | — | $3 | 0.03% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| 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) | UNITEDHEALTHCARE INSURANCE COMPANY | 148 | $1.6M |
| Dental | GUARDIAN | 112 | $247K |
| Vision | GUARDIAN | 112 | $247K |
| Life insurance | GUARDIAN | 112 | $247K |
| Short-term disability | GUARDIAN | 112 | $247K |
| Long-term disability | GUARDIAN | 112 | $247K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 112 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 148 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.