| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $37K | $0 | $37K | 4.18% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | 8950 CAL CENTER DRIVE, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 0.40% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 601 UNIVERSITY AVENUE, SUITE 250 SACRAMENTO, CA 95825 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.63% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | 5401 OLD REDWOOD HIGHWAY, SUITE 105 PETALUMA, CA 94954 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.44% |
| JESSICA HINKLE3 | 601 UNIVERSITY AVENUE, SUITE 250 SACRAMENTO, CA 95825 | WESTERN HEALTH ADVANTAGE | $7K | $0 | $7K | 24.45% |
| JAMES BULOTTI, JR.3 Filed as: JAMES BULOTTI JR. | PO BOX 255188 SACRAMENTO, CA 95865 | WESTERN HEALTH ADVANTAGE | $1K | $0 | $1K | 5.00% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 101 | $915K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $130K |
| Vision | VISION SERVICE PLAN | 107 | $0 |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $130K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 101 | $915K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.