| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $68K | $0 | $68K | 4.05% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND COMPANY, INC. | 669 RIVER DRIVE CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $27K | $27K | 1.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA SERVICES | PO BOX 3310 SANTA BARBARA, CA 93190 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $22K | $0 | $22K | 1.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $4K | $4K | 0.22% |
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA UNIONDALE, NY 11556 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 3.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $326 | $2K | 1.42% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SERVICES, INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 0.85% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMEIRCA | $7K | $0 | $7K | 5.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92503 | LIFE INSURANCE COMPANY OF NORTH AMEIRCA | $6K | $0 | $6K | 4.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 2393 TOWNSGATE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | MAGELLAN HEALTH | $406 | $0 | $406 | 9.99% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 162 | $1.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 162 | $1.7M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 162 | $1.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMEIRCA | 162 | $134K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMEIRCA | 162 | $134K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMEIRCA | 162 | $134K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 162 | $1.9M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMEIRCA | 249 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.