| 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 | $1K | $11K | 11.14% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $632 | $632 | 1.13% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $149 | $2K | 16.21% |
| ONE SOURCE ADVISORS INC Filed as: ONE SOURCE ADVISORS LLC | 1151 SOURZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 19.69% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $645 | — | $645 | 8.26% |
| JOSEPHINE EBALO BACCAY | 3812 AETNA SPRINGS WAY SACRAMENTO, CA 95834 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.47% |
| DARRYL W VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.31% |
| LUCAS ALLEN SCHAFER | PO BOX 2140 FOLSOM, CA 95673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.15% |
| SOTERIA PARTNERS LLC | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT & RISK MANAGEMENT EIN 68-0306908 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 80 IRON POINT CIRCLE FOLSOM, CA 95630 | $345K |
| DICKERSON EMPLOYEE BENEFITS EIN 20-4609434 BROKER & CONSULTANT | Consulting (general); Insurance agents and brokers Service code 16 | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | $313K |
| PAYCHEX EIN 47-0900851 PAYROLL SERVICES | Contract Administrator Service code 13 | 50 IRON POINT RD SUITE 200 FOLSOM, CA 95630 | $140K |
| CA CHARTER SCHOOLS CONFERENCE EIN 51-0465703 MARKETING | Other services Service code 49 | 1277 UNIVERSITY OF OREGON EUGENE, OR 97403 | $43K |
| BRANCHE JONES EIN 57-3276370 CONSULTANT | Consulting (general) Service code 16 | 1127 11TH ST., STE 321 SACRAMENTO, CA 95814 | $25K |
| SINGERLEWAK LLP EIN 95-2302617 TAX AND AUDIT | Accounting (including auditing) Service code 10 | 10960 WILSHIRE BLVD., SUITE 1100 LOS ANGELES, CA 90024 | $24K |
| BUCHALTER EIN 95-2640846 LEGAL | Legal Service code 29 | 1000 WILSHIRE BLVD SUITE 1500 LOS ANGELES, CA 90017 | $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 | $9K |
| TEAGUE INSURANCE AGENCY, INC EIN 95-3063524 INSURANCE COMPANY | Insurance agents and brokers Service code 22 | 4700 SPRING STREET, 400 LA MESA, CA 91942 | $9K |
| INNOVATIVE EXECUTIVE MGMT EIN 84-3449040 CONSULTANT | Other services Service code 49 | 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 | 2,079 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,079 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,312 | $12.8M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 2,587 | $75K |
| Vision | VISION SERVICE PLAN | 1,217 | $236K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,739 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,587 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.