| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $14K | $14K | 4.39% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $59 | $9K | 13.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 6701 CENTER DRIVE W SUITE 1500 LOS ANGELES, CA 900451561 | METROPOLITAN LIFE INSURANCE COMPANY | $48 | $0 | $48 | 0.07% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET SUITE 200 IRVINE, CA 926146271 | METROPOLITAN LIFE INSURANCE COMPANY | -$15 | $0 | -$15 | -0.02% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $46 | $11K | 22.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES INC | PO BOX 2158 RIVERSIDE, CA 925162158 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 4.35% |
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 | 997 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,004 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 475 | $2.0M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,197 | $325K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,499 | $90K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,197 | $325K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,197 | $325K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,197 | $325K |
| Other(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,197 | $443K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,499 | — |
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."
No prospect flags tripped on this filing.