| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GRAYBILL INSURANCE AGENCY, INC.3 | 101 PARKSHORE DR., STE. 100 FOLSOM, CA 95630 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $25K | — | $25K | 7.31% |
| AMWINS3 Filed as: LISI INC. | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $9K | $9K | 2.62% |
| GRAYBILL INSURANCE AGENCY, INC.3 | 101 PARKSHORE DR., SUITE 100 FOLSOM, CA 95630 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 4.90% |
| GRAYBILL INSURANCE AGENCY, INC.3 | 101 PARKSHORE DR., SUITE 100 FOLSOM, CA 95630 | THE GUARDIAN LIFE INSRUANCE COMPANY OF AMERICA NEW YORK | $24K | — | $24K | 12.89% |
| GRAYBILL INSURANCE AGENCY, INC.3 | 101 PARKSHORE DR., SUITE 100 FOLSOM, CA 95630 | KAISER FOUNDATION HEALTH PLAN OF NORTHWEST | $6K | — | $6K | 3.25% |
| GRAYBILL INSURANCE AGENCY, INC.3 | 101 PARKSHORE DR., SUITE 100 FOLSOM, CA 95630 | TRUSTMARK INSURANCE COMPANY | $1K | — | $1K | 18.56% |
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 | 160 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 77 | $832K |
| Dental | THE GUARDIAN LIFE INSRUANCE COMPANY OF AMERICA NEW YORK | 160 | $186K |
| Vision | THE GUARDIAN LIFE INSRUANCE COMPANY OF AMERICA NEW YORK | 160 | $186K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSRUANCE COMPANY OF AMERICA NEW YORK | 160 | $193K |
| Short-term disability | THE GUARDIAN LIFE INSRUANCE COMPANY OF AMERICA NEW YORK | 160 | $186K |
| Long-term disability | THE GUARDIAN LIFE INSRUANCE COMPANY OF AMERICA NEW YORK | 160 | $186K |
| Other | THE GUARDIAN LIFE INSRUANCE COMPANY OF AMERICA NEW YORK | 160 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.