| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 01982 | BLUE CROSS OF CALIFORNIA | $525K | $0 | $525K | 5.34% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $90K | $0 | $90K | 15.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 700 AIRPORT BOULEVARD, SUITE 300 BURLINGAME, CA 94010 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $5K | $14K | 35.66% |
| RSC INSURANCE BROKERAGE INC4 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 01982 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $3K | $0 | $3K | 10.86% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL | 2000 SOUTH COLORADO BOULEVARD TOWER 2, SUITE 150 DENVER, CO 80222 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $209 | $0 | $209 | 0.89% |
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 | 467 | 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) | 467 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 985 | $9.8M |
| Dental | BLUE CROSS OF CALIFORNIA | 985 | $9.8M |
| Vision | BLUE CROSS OF CALIFORNIA | 985 | $9.8M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 467 | $603K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 467 | $603K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 467 | $642K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 985 | $9.8M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 467 | $626K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 985 | — |
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.