| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK MATHIAS3 | 12 PALMWOOD IRVINE, CA 92618 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $105K | $0 | $105K | 2.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92502 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $75K | $0 | $75K | 2.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 4.10% |
| MARK MATHIAS3 Filed as: MARK E. MATHIAS | 12 PALMWOOD IRVINE, CA 92618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 1.93% |
| MARK MATHIAS3 | 12 PALMWOOD IRVINE, CA 92618 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 6.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 1.90% |
| MARK MATHIAS3 | 12 PALMWOOD IRVINE, CA 92618 | VISION SERVICE PLAN | $985 | $0 | $985 | 4.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $554 | $0 | $554 | 2.39% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 122 | $3.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 122 | $191K |
| Vision | VISION SERVICE PLAN | 121 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $54K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $54K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $54K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 122 | $3.6M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.