| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $72K | $0 | $72K | 4.59% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN INC. | $115 | — | $115 | 0.01% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | PREMIER ACCESS INSURANCE COMPANY | $10K | — | $10K | 5.67% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | UNION SECURITY INSURANCE COMPANY, INC. | $13K | $0 | $13K | 14.57% |
| WORKSITE BROKERS3 | 2323 GRAND BLVD KANSAS CITY, MT 64108 | UNION SECURITY INSURANCE COMPANY, INC. | $0 | $1K | $1K | 1.35% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE STE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY, INC. | $1K | $0 | $1K | 1.16% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 | 3435 AMERICAN RIVER DR STE C SACRAMENTO, CA 95864 | VISION SERVICE PLAN | $2K | — | $2K | — |
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 | 370 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 370 | $3.0M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 310 | $173K |
| Vision | VISION SERVICE PLAN | 314 | $0 |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 370 | $1.7M |
| Short-term disability | UNION SECURITY INSURANCE COMPANY, INC. | 61 | $88K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY, INC. | 61 | $88K |
| Prescription drug | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 370 | $1.6M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 370 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.