| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN, INC. | $43K | $0 | $43K | 5.91% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | $0 | $9K | 1.23% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS. SVCS, LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | -$13K | $0 | -$13K | -1.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | UNKNOWN RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | $0 | $17K | 6.70% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD SUITE 400 WALNUT CREEK, CA 94596 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $0 | $9K | 3.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $5K | $5K | 1.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 203 NORTH LA SALLE STREET 20TH FLOOR CHICAGO, IL 60601 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | $0 | $6K | 13.69% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD SUITE 400 WALNUT CREEK, CA 94596 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $586 | $0 | $586 | 1.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN, INC. | $168 | $0 | $168 | 2.93% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD SUITE 400 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $50 | $0 | $50 | 0.87% |
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 | 723 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 745 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 104 | $739K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 723 | $256K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 723 | $256K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 723 | $256K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 104 | $739K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 723 | $300K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 723 | — |
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.