| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 6400 SOUTH FIDDLERS GREEN CIRCLE SUITE 2000 GREENWOOD VILLAGE, CO 80111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $0 | $13K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 1.98% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 745977 LOS ANGELES, CA 90074 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $2K | $5K | 22.63% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $2 | $0 | $2 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $630 | $0 | $630 | 10.01% |
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 | 105 | 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) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 6 | $33K |
| Vision | VISION SERVICE PLAN | 105 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 105 | $89K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 105 | $89K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 105 | $89K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 6 | $33K |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 105 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.