| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE AGENCY | PO DRAWER 1189 STE 300 SAN LUIS OBISPO, CA 93406 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $52K | — | $52K | 5.59% |
| MARK MOKRYCKI3 | 3729 LEXINGTON RD MICHIGAN CITY, IN 46360 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $367 | $367 | 0.04% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE AGENCY | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 5.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | -$121 | — | -$121 | -0.04% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INS AGENCY | 1122 LAUREL LN SAN LUIS OBISPO, CA 93406 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $725 | — | $725 | 10.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 5375 MIRA SORRENTO PL #400 SAN DIEGO, CA 92121 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $459 | $459 | 6.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2158 RIVERSIDE, CA 92501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $317 | — | $317 | 4.56% |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 258 | $1.2M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 258 | $932K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 258 | $932K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 258 | $939K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 67 | $301K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 46 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.