| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 3636 AMERICAN RIVER DR., 2ND FLOOR SACRAMENTO, CA 95864 | CALIFORNIA PHYSICIANS SERVICE | $25K | $0 | $25K | 4.00% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 8950 CAL CENTER DRIVE BLDG 3, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $0 | $14K | 3.24% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 1357A EAST LASSEN AVENUE CHICO, CA 95973 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $272 | $272 | 0.06% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | PO BOX 255188 SACRAMENTO, CA 95865 | STANDARD INSURANCE COMPANY | $8K | $2K | $10K | 4.30% |
| JAMES A. BULOTTI3 | 3636 AMERICAN RIVER DRIVE 2ND FLOOR SACRAMENTO, CA 95864 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $869 | $0 | $869 | 16.71% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 3636 AMERICAN RIVER DR., 2ND FLOOR SACRAMENTO, CA 95864 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $162 | $0 | $162 | 4.00% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 84 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 132 | $232K |
| Long-term disability | STANDARD INSURANCE COMPANY | 132 | $228K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 84 | $1.1M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 132 | $237K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.