| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 7072 PASADENA, CA 91109 | BLUE CROSS OF CALIFORNIA | $63K | — | $63K | 2.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | BLUE CROSS OF CALIFORNIA | $32K | — | $32K | 1.29% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 232017 PLEASANT HILL, CA 94523 | BLUE CROSS OF CALIFORNIA | $10K | — | $10K | 0.42% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 743376 LOS ANGELES, CA 900743376 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 3.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $1 | $4K | 1.49% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | DBA INTEGRO INSURANCE BROKERS P.O. BOX 101809 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $22 | $14K | 5.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $3K | $8K | 3.35% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 101809 PASADENA, CA 911891809 | THE LINCOLN LIFE INSURANCE COMPANY | $4K | — | $4K | 9.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN LIFE INSURANCE COMPANY | $3K | — | $3K | 5.63% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 101809 PASADENA, CA 911891809 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.65% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 101809 PASADENA, CA 911891809 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $928 | — | $928 | 3.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $299 | $1K | 6.72% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 101809 PASADENA, CA 911891809 | METROPOLITAN LIFE INSURANCE COMPANY | $682 | $22 | $704 | 3.39% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 101809 PASADENA, CA 911891809 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $22 | $2K | 11.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $872 | $232 | $1K | 7.11% |
| INTEGRO INSURANCE BROKERS3 | P.O. BOX 101809 PASADENA, CA 911891809 | LEGALPLANS | — | $689 | $689 | 19.99% |
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 | 345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 257 | $2.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 569 | $249K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 569 | $249K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 397 | $45K |
| Short-term disability | THE LINCOLN LIFE INSURANCE COMPANY | 296 | $46K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 397 | $25K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 257 | $2.5M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 397 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 569 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.