| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNITEDHEALTHCARE INSURANCE COMPANY | $308K | $0 | $308K | 5.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $103K | $0 | $103K | 2.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $2K | $25K | 12.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3440 WALNUT, BLD A, 2ND FLOOR SUITE 33667 FREMONT, CA 94538 | EYEMED VISION CARE | $10K | $0 | $10K | 10.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PREMIER ACCESS INSURANCE COMPANY | $5K | $0 | $5K | 12.14% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 15.00% |
| JOHN W. WANE3 | 511 WEST A STREET YAKIMA, WA 98902 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $970 | $0 | $970 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | GERBER LIFE INSURANCE COMPANY | $938 | $0 | $938 | 15.01% |
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 | 889 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 895 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 850 | $9.6M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 347 | $40K |
| Vision | EYEMED VISION CARE | 1,615 | $103K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 930 | $203K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 930 | $203K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 930 | $203K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 850 | $9.6M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 930 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,615 | — |
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.