| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPTIVE INS SERVICES INC3 Filed as: CAPTIVE INS SERVICES INC. | 800 CORPORATE DR STE 600 FORT LAUDERDALE, FL 333343621 | METROPOLITAN LIFE INSURANCE COMPANY | $246K | — | $246K | 13.15% |
| CAPTIVE INSURANCE SERVICES3 Filed as: CAPTIVE INSURANCE SERVICES INC | 800 CORPORATE DRIVE FORT LAUDERDALE, FL 33334 | BLUE CROSS OF CALIFORNIA | $43K | — | $43K | 3.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $13K | — | $13K | 1.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $9K | — | $9K | 0.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | — | $2K | $2K | 0.14% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC | PO BOX 2158 RIVERSIDE, CA 92516 | BLUE CROSS OF CALIFORNIA | — | $329 | $329 | 0.03% |
| CAPTIVE INSURANCE SERVICES3 Filed as: CAPTIVE INSURANCE SERVICES INC | 800 CORPORATE DRIVE #600 FT LAUDERDALE, FL 33334 | HUMANA HEALTH PLAN, INC. | $22K | — | $22K | 3.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4695 MAC ARTHUR COURT SUITE 600 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $10K | — | $10K | 2.19% |
| CAPTIVE INS SERVICES INC3 Filed as: CAPTIVE INSURANCE SERVICES DBA ALPH | 800 CORPORATE DRIVE STE #600 FORT LAUDERDALE, FL 33334 | EYEMED VISION CARE | $36K | — | $36K | 15.21% |
| CAPTIVE INSURANCE SERVICES3 Filed as: CAPTIVE INSURANCE SERVICES INC | 800 CORPORATE DRIVE #600 FT LAUDERDALE, FL 33334 | HUMANA INSURANCE COMPANY | $8K | — | $8K | 3.30% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DR STE 600 FORT LAUDERDALE, FL 333343621 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 9.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 5345 RIVERSIDE, CA 92517 | METROPOLITAN LIFE INSURANCE COMPANY | $396 | $48 | $444 | 0.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LTD | 1393 VETERANS HWY STE 210N HAUPPAUGE, NY 11788 | METROPOLITAN LIFE INSURANCE COMPANY | — | $252 | $252 | 0.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | ATTN ANN INGRAM PO BOX 3716 NORFOLK, VA 23514 | METROPOLITAN LIFE INSURANCE COMPANY | — | $24 | $24 | 0.02% |
| KYLE KELLY3 Filed as: KYLE R KELLY | 800 CORPORATE DRIVE, STE. 600 FT LAUDERDALE, FL 33334 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $3K | — | $3K | 1.97% |
| KYLE KELLY3 Filed as: KYLE R KELLY | 800 CORPORATE DRIVE, STE. 600 FT LAUDERDALE, FL 33334 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | -$32 | — | -$32 | -0.02% |
| KYLE KELLY3 | 800 CORPORATE DRIVE STE 600 FORT LAUDERDALE, FL 33334 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $9K | — | $9K | 6.80% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DR STE 600 FORT LAUDERDALE, FL 333343621 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $4K | — | $4K | 2.96% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DR STE 600 FORT LAUDERDALE, FL 333343621 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | — | $16K | 13.38% |
| CAPTIVE INS SERVICES INC3 Filed as: CAPTIVE INSURANCE SERVICES DBA ALPH | 800 CORPORATE DRIVE STE #600 FORT LAUDERDALE, FL 33334 | EYEMED VISION CARE | $17K | — | $17K | 15.08% |
| CAPTIVE INS SERVICES INC3 Filed as: CAPTIVE INSURANCE SERVICES DBA ALPH | 800 CORPORATE DRIVE FORT LAUDERDALE, FL 33334 | EYEMED VISION CARE | $4K | — | $4K | 15.16% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DRIVE SUITE 600 FORT LAUDERDALE, FL 33334 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $2K | — | $2K | 10.13% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DR STE 600 FORT LAUDERDALE, FL 33334 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | — | $2K | 12.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 5345 RIVERSIDE, CA 92517 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $34 | $4 | $38 | 0.30% |
| KYLE KELLY3 | 800 CORPORATE DR STE 600 FORT LAUDERDALE, FL 33334 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $1K | — | $1K | 9.60% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DRIVE SUITE 600 FORT LAUDERDALE, FL 33334 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $658 | — | $658 | 15.05% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DRIVE SUITE 600 FORT LAUDERDALE, FL 33334 | SAFEGUARD HEALTH PLANS., A FLORIDA CORPORATION | $603 | — | $603 | 18.44% |
| CAPTIVE INS SERVICES INC3 | 800 CORPORATE DRIVE SUITE 600 FORT LAUDERDALE, FL 33334 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $256 | — | $256 | 10.03% |
| CAPTIVE INS SERVICES INC3 Filed as: CAPTIVE INSURANCE SERVICES DBA ALPH | 800 CORPORATE DRIVE STE #600 FORT LAUDERDALE, FL 33334 | EYEMED VISION CARE | $208 | — | $208 | 15.76% |
| CAPTIVE INS SERVICES INC3 Filed as: CAPTIVE INSURANCE SERVICES DBA ALPH | 800 CORPORATE DRIVE FORT LAUDERDALE, FL 33334 | EYEMED VISION CARE | -$216 | — | -$216 | -27.14% |
| CAPTIVE INS SERVICES INC3 Filed as: CAPTIVE INSURANCE SERVICES DBA ALPH | 800 CORPORATE DRIVE STE #600 FORT LAUDERDALE, FL 33334 | EYEMED VISION CARE | $56 | — | $56 | 17.13% |
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 | 2,034 | 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) | 2,034 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | BLUE CROSS OF CALIFORNIA | 208 | $2.7M |
| Dental(10 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,709 | $2.3M |
| Vision(10 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,141 | $2.7M |
| Life insurance(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 2,709 | $2.1M |
| Short-term disability(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 2,709 | $2.1M |
| Long-term disability(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 2,709 | $2.1M |
| Other(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,709 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,141 | — |
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.