| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL CITY BENEFITS3 Filed as: CAPITAL CITY BENEFITS & INS SVCS | 400 SUNRISE AVE SUITE 250 ROSEVILLE, CA 95661 | BLUE CROSS OF CALIFORNIA | $23K | — | $23K | 3.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | BLUE CROSS OF CALIFORNIA | — | $8K | $8K | 1.11% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $5K | — | $5K | 0.74% |
| CAPITAL CITY BENEFITS3 Filed as: CAPITAL CITY BENEFITS & INS SVCS | 400 SUNRISE AVE SUITE 250 ROSEVILLE, CA 95661 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | — | $14K | 2.49% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | — | $14K | 2.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 1.39% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 4.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 3.94% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.43% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 7.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 7.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $786 | — | $786 | 7.71% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $744 | — | $744 | 7.29% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $927 | — | $927 | 10.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $903 | — | $903 | 9.87% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $698 | — | $698 | 10.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $692 | — | $692 | 9.95% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $587 | — | $587 | 10.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $555 | — | $555 | 9.72% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $213 | — | $213 | 7.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $197 | — | $197 | 7.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BLVD STE 410 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $55 | — | $55 | 8.90% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $38 | — | $38 | 6.15% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 86 | $1.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 163 | $76K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 155 | $12K |
| Life insurance(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 107 | $25K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 30 | $10K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 107 | $17K |
| Other(5 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 107 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.