| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 92008 | BLUE CROSS OF CALIFORNIA | $31K | $280 | $31K | 5.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMINISTRATORS INC | 721 S PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | — | $13K | $13K | 2.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 92108 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $19 | $2K | 5.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMINISTRATORS INC | 721 S PARKER STREET ORANGE, CA 92868 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $849 | $849 | 2.05% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $1K | — | $1K | 16.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 1525 FARADAY AVENUE, SUITE 200 CARLSBAD, CA 92108 | STANDARD INSURANCE COMPANY | $739 | $87 | $826 | 19.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMINISTRATORS INC | 721 S PARKER STREET ORGANCE, CA 92868 | STANDARD INSURANCE COMPANY | — | $246 | $246 | 5.70% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 77 | $617K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 115 | $41K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 115 | $41K |
| Life insurance(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 120 | $56K |
| Short-term disability | AFLAC | 13 | $9K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 77 | $617K |
| Other(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 120 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.