| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PURVES AND ASSOCIATES3 Filed as: PURVES AND ASSOC INS AGENCY | 500 4TH STREET DAVIS, CA 95616 | CALIFORNIA CHOICE | $58K | $0 | $58K | 5.00% |
| PURVES AND ASSOCIATES3 | 500 4TH STREET DAVIS, CA 95616 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 5.53% |
| CELITA ANN PEDRO3 | 6705 MIRAVISTA DR ROCKLIN, CA 95677 | AFLAC | $1K | $37 | $1K | 7.02% |
| PURVES AND ASSOCIATES3 Filed as: PURVES & ASSOCIATES | 500 4TH STREET DAVIS, CA 95616 | AFLAC | $250 | $0 | $250 | 1.49% |
| JACE KUERSTEIN3 | 507 GARWOOD CT VACAVILLE, CA 95687 | AFLAC | $224 | $7 | $231 | 1.37% |
| PETER JAMES SARANTIS3 | 2251 DOUGLAS BLVD SUITE 110 ROSEVILLE, CA 95661 | AFLAC | $134 | $10 | $144 | 0.86% |
| DARRYL W VIDOR3 Filed as: DARRYL VIDOR | 4030 LENNANE DR SACRAMENTO, CA 95834 | AFLAC | $125 | $0 | $125 | 0.74% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEN IN SERVICES | 4416 VIA PALAGIO FAIR OKAS, CA 95628 | AFLAC | $78 | $10 | $88 | 0.52% |
| APRIL MARIE ROBERTS3 | 62 N MARKET ST STE 310 WAILUKU, HI 96793 | AFLAC | $84 | $0 | $84 | 0.50% |
| BARRY A WHITE3 Filed as: BARRY WHITE | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $68 | $0 | $68 | 0.40% |
| LINDA BAILEY3 | 6505 DEADERICK CT ORANGEVALE, CA 95662 | AFLAC | $50 | $0 | $50 | 0.30% |
| REBECCA STUART-GRISHAM3 | P.O BOX 202 GARDEN VALLEY, CA 95633 | AFLAC | $33 | $0 | $33 | 0.20% |
| RAMONA HERRIFORD3 | P.O. BOX 278867 SACRAMENTO, CA 95827 | AFLAC | $29 | $0 | $29 | 0.17% |
| BARBARA GARLAND3 | 1510 YELLOWSTONE CT ROCKLIN, CA 95765 | AFLAC | $26 | $0 | $26 | 0.15% |
| MONA RAYE CHAPIN3 | 7520 SONG SPARROW WAY ELK GROVE, CA 95758 | AFLAC | $11 | $13 | $24 | 0.14% |
| CAROLYN LEWIS3 | 3904 HILLS CT EL DORADO HILLS, CA 95762 | AFLAC | $22 | $0 | $22 | 0.13% |
| DAVID B. KITCHEN3 Filed as: DAVID KITCHEN | 1260 N DUTTON AVE STE 180 SANTA ROSA, CA 95401 | AFLAC | $14 | $3 | $17 | 0.10% |
| ROBERT BENEFIEL3 | 207 N GILBERT RD STE 001 GILBERT, AZ 85234 | AFLAC | $13 | $0 | $13 | 0.08% |
| TYLER BENNETT3 | 2280 E BIDWELL ST 200 FOLSOM, CA 95630 | AFLAC | $8 | $0 | $8 | 0.05% |
| CELITA ANN PEDRO3 Filed as: CELITA PEDRO | 6705 MIRAVISTA DR ROCKLIN, CA 95677 | AFLAC | $168 | $0 | $168 | 4.71% |
| PURVES AND ASSOCIATES3 | 500 4TH STREET DAVIS, CA 95616 | AFLAC | $68 | $0 | $68 | 1.91% |
| ROBERT BENEFIEL3 | 3107 E BLUE RIDGE WAY GILBERT, AZ 85298 | AFLAC | $45 | $0 | $45 | 1.26% |
| LINDA BAILEY3 | 6505 DEADERICK CT ORANGEVALE, CA 95662 | AFLAC | $36 | $0 | $36 | 1.01% |
| BARBARA GARLAND3 | 1510 YELLOWSTONE CT ROCKLIN, CA 95765 | AFLAC | $25 | $0 | $25 | 0.70% |
| DARRYL W VIDOR3 Filed as: DARRYL VIDOR | 4030 LENNANE DR SACRAMENTO, CA 95834 | AFLAC | $21 | $0 | $21 | 0.59% |
| BARRY A WHITE3 Filed as: BARRY WHITE | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $19 | $0 | $19 | 0.53% |
| REBECCA STUART-GRISHAM3 | PO BOX 202 GARDEN VALLEY, CA 95633 | AFLAC | $15 | $0 | $15 | 0.42% |
| APRIL MARIE ROBERTS3 Filed as: APRIL ROBERTS | 62 N MARKET SUITE 310 WAILUKU, HI 96793 | AFLAC | $14 | $0 | $14 | 0.39% |
| TYLER BENNETT3 | 2280 E BIDWELL ST #200 FOLSOM, CA 95630 | AFLAC | $8 | $0 | $8 | 0.22% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $5 | $0 | $5 | 0.14% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 111 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $181K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $181K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $181K |
| Short-term disability(2 contracts) | AFLAC | 28 | $20K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $181K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.