| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 926301771 | UNITEDHEALTHCARE INSURANCE COMPANY | $31K | — | $31K | 4.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 0.43% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $5K | $9K | 10.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $174 | — | $174 | 0.19% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC. | 23716 BIRTCHER LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $276 | — | $276 | 12.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $53 | — | $53 | 2.41% |
| JOHN E. GREGORY3 | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5 | $5 | 0.23% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 98 | $676K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $93K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $93K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $95K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 126 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.