| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | BLUE SHIELD OF CALIFORNIA | $47K | — | $47K | 6.42% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD. SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA | $15K | — | $15K | 2.01% |
| JOHNANNA HAAS3 | 828 BLACKWOOD AVE. CLOVIS, CA 93619 | AFLAC | $11K | $494 | $12K | 13.43% |
| ILIC-STONE INS SERVICES INC3 Filed as: ILIC-STONE INS SERVICES, INC. | 1285 W SHAW AVE. SUITE 101 FRESNO, CA 93711 | AFLAC | $2K | $143 | $2K | 2.67% |
| LORELEI A ZENTMYER3 | 750 W ALLUVIAL AVE. APT. 1066 CLOVIS, CA 93611 | AFLAC | $2K | $83 | $2K | 2.44% |
| REBECCA A ROBINSON3 | 7302 W PORTALS AVE. FRESNO, CA 93723 | AFLAC | $2K | $115 | $2K | 2.24% |
| KIMBERLEY LYNN SCHMALL3 Filed as: KIMBERLEY L SCHMALL | 9925 N GRANDVILLE AVE. FRESNO, CA 93720 | AFLAC | $1K | $137 | $1K | 1.38% |
| JOSEPH LINVILLE3 | 1285 W SHAW AVE. SUITE 101 FRESNO, CA 93711 | AFLAC | $939 | — | $939 | 1.05% |
| JOHN L WENDER INSURANCE SERVICES3 Filed as: JOHN M ZENTMYER | 247 E PORTLAND AVE. FRESNO, CA 93720 | AFLAC | $315 | — | $315 | 0.35% |
| RHONDA V PHILLIPS3 | 1334 W DAYTON AVE. FRESNO, CA 93705 | AFLAC | $172 | $27 | $199 | 0.22% |
| ROBERT WILKINS3 Filed as: ROBERT D WILKINS | 134 NW 19TH ST. ONTARIO, OR 97914 | AFLAC | $179 | — | $179 | 0.20% |
| CHARLES EDWARD PERRY3 | 12858 TORREY PINES DR. AUBURN, CA 95602 | AFLAC | $112 | — | $112 | 0.13% |
| D BREDESON INSURANCE SERVICES INC3 Filed as: BREDESON INSURANCE SERVICES, INC. | 641 HIGUERA ST. SUITE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $49 | — | $49 | 0.05% |
| GARY LOWE3 | 13106 NANTUCKLET PL. BAKERSFIELD, CA 93314 | AFLAC | $44 | — | $44 | 0.05% |
| ANA PATRICIA ARRIAGA3 | 1115 GRAY AVE. YUBA CITY, CA 95991 | AFLAC | $40 | — | $40 | 0.04% |
| RYAN OLSON3 Filed as: RYAN T OLSON | 1294 E 1ST AVE. CHICO, CA 95927 | AFLAC | $20 | — | $20 | 0.02% |
| CAELUM INC3 Filed as: CAELUM, INC. | 13295 CALLE DEL CAMPO UNIT 2 SAN DIEGO, CA 92129 | AFLAC | $8 | — | $8 | 0.01% |
| BRENDA S HAMILTON3 Filed as: BRENDA HAMILTON | 37 BIRCH AVE. CLOVIS, CA 93611 | AFLAC | $6 | — | $6 | 0.01% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD. ROSEVILLE, CA 95678 | AFLAC | $3 | — | $3 | 0.00% |
| STACIE L BENDER3 | 2406 WINDERMERE ST. BAKERSFIELD, CA 93311 | AFLAC | $2 | — | $2 | 0.00% |
| MARICELA SANCHEZ3 | 509 E BROWNING AVE. HERMISTIN, OR 97838 | AFLAC | $2 | — | $2 | 0.00% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 641 HIGUERA ST. SUITE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $1 | — | $1 | 0.00% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 4.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES, INC. | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN, INC. | $51 | — | $51 | 0.14% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $377 | $2K | 22.79% |
| WILLNER-CARDINET-KIDWELL3 | 333 N INDIAN HILL BLVD. CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24 | — | $24 | 0.24% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN, INC. | $171 | — | $171 | 2.91% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | BLUE SHIELD OF CALIFORNIA | $290 | — | $290 | 6.20% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD. SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA | $95 | — | $95 | 2.03% |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 91 | $772K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 87 | $10K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 87 | $10K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 117 | $94K |
| Short-term disability | AFLAC | 46 | $89K |
| Prescription drug(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 91 | $772K |
| Other | BLUE SHIELD OF CALIFORNIA | 117 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.