| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | BLUE CROSS OF CALIFORNIA | $71K | $10K | $81K | 2.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | BLUE CROSS OF CALIFORNIA | $41K | — | $41K | 1.48% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN INC. | $34K | — | $34K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $31K | — | $31K | 2.26% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $569 | $9K | 10.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $229 | $4K | 5.43% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $422 | $8K | 11.55% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTERE SUITE 500 SAN DIEGO, CA 92122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $163 | $4K | 5.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE, SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $232 | $1K | 6.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $918 | $115 | $1K | 4.97% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $200 | $1K | 6.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $968 | $121 | $1K | 5.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $927 | $116 | $1K | 6.18% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTERE SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $761 | $152 | $913 | 5.41% |
| MARSH & MCLENNAN AGENCY LLC3 | BARNEY BARNEY 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $383 | — | $383 | 15.01% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DR. TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $530 | — | $530 | 24.75% |
| MARSH & MCLENNAN AGENCY LLC4 Filed as: BARNEY & BARNEY A MARSH & MCLENNAN | P.O. BOX 85638 SAN DIEGO, CA 92186 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $152 | — | $152 | 7.10% |
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 | 456 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 502 | $4.2M |
| Dental | BLUE CROSS OF CALIFORNIA | 502 | $2.8M |
| Vision | BLUE CROSS OF CALIFORNIA | 502 | $2.8M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 502 | $2.9M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 31 | $21K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 20 | $37K |
| Other(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 502 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 502 | — |
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.