| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | $0 | $10K | 1.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIGINIA BEACH, VA 234666119 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | $0 | $4K | 0.53% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | WESTERN HEALTH ADVANTAGE | $7K | $0 | $7K | 7.99% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | DELTA DENTAL OF CALIFORNIA | $0 | $0 | $0 | 0.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN, INC. | $789 | $0 | $789 | 1.91% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIGINIA BEACH, VA 234666119 | KAISER FOUNDATION HEALTH PLAN, INC. | $351 | $0 | $351 | 0.85% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | DELTA DENTAL OF CALIFORNIA | $0 | $0 | $0 | 0.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | BLUE SHIELD OF CALIFORNIA (LIFE) | $0 | $0 | $0 | 0.00% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | GERBER LIFE INSURANCE CO. (MESVISION) | $70 | $0 | $70 | 4.99% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | GERBER LIFE INSURANCE CO. (MESVISION) | $14 | $0 | $14 | 4.83% |
| AMES-GRENZ INSURANCE SERVICES, INC.3 Filed as: AMES GRENZ INSURANCE SERVICES INC | 3435 AMERICAN RIVER DRIVE SUITE C SACRAMENTO, CA 95864 | CIGNA GROUP INSURANCE | $0 | $0 | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIGINIA BEACH, VA 234666119 | CYPRESS DENTAL ADMINISTRATORS | $11 | $0 | $11 | 7.86% |
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 | 60 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 60 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 64 | $719K |
| Dental | CYPRESS DENTAL ADMINISTRATORS | 11 | $140 |
| Vision(3 contracts, 2 carriers) | GERBER LIFE INSURANCE CO. (MESVISION) | 11 | $2K |
| Life insurance(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA (LIFE) | 15 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 80 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.