| 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 | $9K | $887 | $10K | 12.05% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $403 | $403 | 1.00% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $129 | $1K | 18.12% |
| ONE SOURCE ADVISORS INC Filed as: ONE SOURCE ADVISORS LLC | 1151 SOURZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $610 | — | $610 | 15.10% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $366 | — | $366 | 9.06% |
| JOSEPHINE EBALO BACCAY | 3812 AETNA SPRINGS WAY SACRAMENTO, CA 95834 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | $45 | $104 | 2.57% |
| DARRYL W VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.62% |
| LUCAS ALLEN SCHAFER | PO BOX 2140 FOLSOM, CA 95673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.35% |
| SOTERIA PARTNERS LLC | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DICKERSON EMPLOYEE BENEFITS EIN 20-4609434 BROKER & CONSULTANT | Insurance agents and brokers; Consulting (general) Service code 16 | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | $388K |
| BENEFIT & RISK MANAGEMENT EIN 68-0306908 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 80 IRON POINT CIRCLE FOLSOM, CA 95630 | $209K |
| PAYCHEX EIN 47-0900851 PAYROLL SERVICES | Contract Administrator Service code 13 | 50 IRON POINT RD SUITE 200 FOLSOM, CA 95630 | $137K |
| BRANCHE JONES EIN 57-3276370 CONSULTANT | Consulting (general) Service code 16 | 1127 11TH ST., STE 321 SACRAMENTO, CA 95814 | $25K |
| CA CHARTER SCHOOLS CONFERENCE EIN 51-0465703 MARKETING | Other services Service code 49 | 1277 UNIVERSITY OF OREGON EUGENE, OR 97403 | $22K |
| SINGERLEWAK LLP EIN 95-2302617 TAX AND AUDIT | Accounting (including auditing) Service code 10 | 10960 WILSHIRE BLVD., SUITE 700 LOS ANGELES, CA 90024 | $19K |
| NATASHAY STARR EIN 48-2900736 CONSULTANT | Consulting (general) Service code 16 | 354 KENILWORTH CIRCLE STONE MOUNTAIN, GA 30083 | $12K |
| ALCALA CONSULTING, INC. EIN 91-1947256 CONSULTANT | Consulting (general) Service code 16 | PO BOX 845724 LOS ANGELES, CA 90084 | $10K |
| NYLOR, LLC EIN 20-3140220 MARKETING | Other services Service code 49 | P.O. BOX 677251 DALLAS, TX 75267 | $9K |
| CHARTER SCHOOLS DEVELOPMENT CENTER EIN 86-1070577 MARKETING | Other services Service code 49 | 817 14TH STREET, SUITE 300 SACRAMENTO, CA 95814 | $8K |
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 | 1,758 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,758 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 604 | $9.5M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL | 2,384 | $491K |
| Vision | VISION SERVICE PLAN | 1,278 | $196K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,507 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,384 | — |
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.