| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $783 | $11K | 9.96% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $463 | $463 | 0.70% |
| ONE SOURCE ADVISORS INC Filed as: ONE SOURCE ADVISORS LLC | 1151 SOURZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $426 | — | $426 | 11.55% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $323 | — | $323 | 8.76% |
| DARRYL W VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | $1 | $60 | 1.63% |
| BRAD BIEL | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| SOTERIA PARTNERS LLC | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DICKERSON EMPLOYEE BENEFITS EIN 20-4609434 BROKER & CONSULTANT | Consulting (general); Insurance agents and brokers Service code 16 | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | $499K |
| BENEFIT & RISK MANAGEMENT EIN 68-0306908 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 80 IRON POINT CIRCLE FOLSOM, CA 95630 | $282K |
| PAYCHEX EIN 47-0900851 PAYROLL SERVICES | Contract Administrator Service code 13 | 911 PANARAMA TRAIL SOUTH ROCHESTER, NY 14625 | $137K |
| SINGERLEWAK LLP EIN 95-2302617 TAX AND AUDIT | Accounting (including auditing) Service code 10 | 10960 WILSHIRE BLVD., SUITE 700 LOS ANGELES, CA 90024 | $33K |
| BRANCHE JONES EIN 57-3276370 CONSULTANT | Consulting (general) Service code 16 | 1127 11TH ST., STE 321 SACRAMENTO, CA 95814 | $25K |
| NATASHA GREEN EIN 48-2900736 CONSULTANT | Consulting (general) Service code 16 | P.O. BOX 15944 SACRAMENTO, CA 95852 | $12K |
| ALCALA CONSULTING, INC. EIN 91-1947256 CONSULTANT | Consulting (general) Service code 16 | PO BOX 845724 LOS ANGELES, CA 90084 | $9K |
| CA CHARTER SCHOOLS CONFERENCE EIN 51-0465703 MARKETING | Other services Service code 49 | 1277 UNIVERSITY OF OREGON EUGENE, OR 97403 | $8K |
| BUCHALTER EIN 95-2640846 LEGAL | Legal Service code 29 | 1000 WILSHIRE BLVD SUITE 1500 LOS ANGELES, CA 90017 | $8K |
| TEAGUE INSURANCE AGENCY, INC. EIN 95-3063524 FEDERAL INSURANCE COMPANY | Insurance brokerage commissions and fees Service code 53 | 4700 SPRING ST., 4TH FLR LA MESA, CA 91942 | $7K |
| INNOVATIVE EXECUTIVE MGMT EIN 84-3449040 CONSULTANT | Consulting (general) Service code 16 | 1005 PESCADARO AVE 101 TRACY, CA 95304 | $6K |
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 | 1,991 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,991 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 583 | $11.3M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL | 1,943 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,219 | $244K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,809 | $182K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,943 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.