| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE AGENCY | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | ANTHEM BLUE CROSS | $32K | $0 | $32K | 1.96% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE AGENCY | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | KAISER FOUNDATION HEALTH PLAN INC | $15K | $0 | $15K | 2.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES, INC. | PO BOX 10328 KNOXVILLE, TN 37939 | KAISER FOUNDATION HEALTH PLAN INC | $11K | $0 | $11K | 2.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | PO BOX 10328 KNOXVILLE, TN 37939 | STARMOUNT LIFE INSURANCE COMPANY | $8K | $605 | $9K | 5.69% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE AGENCY | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | STARMOUNT LIFE INSURANCE COMPANY | $7K | $539 | $8K | 5.06% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE AGENCY | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $296 | $6K | 8.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | PO BOX 10328 KNOXVILLE, TN 37939 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $159 | $2K | 2.87% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 NORTH 40TH STREET SUITE 234 PHOENIX, AZ 85018 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.00% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE AGENCY | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | VISION SERVICE PLAN | $869 | $0 | $869 | 3.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE COMPANY | PO BOX 10328 KNOXVILLE, TN 37939 | VISION SERVICE PLAN | $685 | $0 | $685 | 3.11% |
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 | 171 | 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) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 114 | $2.1M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 154 | $153K |
| Vision | VISION SERVICE PLAN | 142 | $22K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $67K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $67K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $67K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 114 | $2.1M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.