| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GRAYBILL INSURANCE AGENCY, INC.3 Filed as: GRAYBILL INSURANCE AGENCY INC | 101 PARKSHORE DR., SUITE 100 FOLSOM, TX 956304726 | BLUE CROSS OF CALIFORNIA | $77K | $0 | $77K | 4.99% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR., SUITE 400S DALLAS, TX 752511800 | BLUE CROSS OF CALIFORNIA | $0 | $31K | $31K | 2.00% |
| GRAYBILL INSURANCE AGENCY, INC.3 Filed as: GRAYBILL INSURANCE AGENCY INC | 101 PARKSHORE DR., SUITE 100 FOLSOM, CA 956304726 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | $0 | $5K | 2.95% |
| GRAYBILL INSURANCE AGENCY, INC.3 Filed as: GRAYBILL INSURANCE AGENCY INC | 101 PARKSHORE DR., SUITE 100 FOLSOM, CA 956304726 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | $0 | $13K | 10.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FINANCIAL SERVI | 12404 PARK CENTRAL DR., SUITE 400S DALLAS, TX 752511800 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.90% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES INC | 32110 AGOURA RD WEST LAKE VILLAGE, CA 913614026 | PRINCIPAL LIFE INSURANCE COMPANY | $313 | $0 | $313 | 0.24% |
| GRAYBILL INSURANCE AGENCY, INC.3 Filed as: GRAYBILL INSURANCE AGENCY INC | 101 PARKSHORE DR., SUITE 100 FOLSOM, CA 956304726 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 12.25% |
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 | 175 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 107 | $1.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 175 | $130K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 175 | $130K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 175 | $194K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 55 | $64K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 55 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.