| 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 | 11.95% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $619 | $619 | 1.38% |
| DANONE SIMPSON INSURANCE SERVICES | 24005 VENTURA BLVD CALABASAS, CA 91302 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $176 | — | $176 | 6.74% |
| ZACHARY HUNYADI ALICEA | 5001 N MESA ST APT 1114 EL PASO, TX 79912 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $121 | — | $121 | 4.63% |
| ONE SOURCE ADVISORS INC Filed as: ONE SOURCE ADVISORS LLC | 1151 SOURZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $105 | — | $105 | 4.02% |
| ONE SOURCE ADVISORS, LLC AND AGENTS Filed as: ONE SOURCE INSURANCE SERVICES INC | 1151 SOURZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 3.37% |
| STEPHANIE NOELLE KUGLER | 21068 VALLEY CIR ELKHORN, NE 98022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 1.72% |
| BRIAN ROBERT LLOYD | 6234 KINGS PEAK DR EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.50% |
| CASEY JAMES KUGLER | 21068 VALLEY CIR ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.31% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.27% |
| DARRYL W VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.23% |
| SOTERIA PARTNERS LLC | 77 HAGGERTY DR WEST ORANGE, NJ 07052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| NATIONAL ENROLLMENT PARTNERS LLC | C/O NATL ENROLLMENT PARTNERS CRANSTON, RI 02920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| 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 | $347K |
| DICKERSON EMPLOYEE BENEFITS EIN 20-4609434 BROKER & CONSULTANT | Consulting (general); Insurance agents and brokers Service code 16 | 333 N. GLENOAKS BLVD, SUITE 410 BURBANK, CA 91502 | $259K |
| AXENE HEALTH PARTNERS LLC EIN 41-2086311 ACTUARIAL CONSULTANT | Actuarial Service code 11 | 24630 WASHINGTON AVE, STE203 MURRIETA, CA 92562 | $45K |
| SINGERLEWAK LLP EIN 95-2302617 TAX AND AUDIT | Accounting (including auditing) Service code 10 | 10960 WILSHIRE BLVD., SUITE 1100 LOS ANGELES, CA 90024 | $32K |
| PAYCHEX EIN 16-1124166 PAYROLL SERVICES | Contract Administrator Service code 13 | 50 IRON POINT RD SUITE 200 FOLSOM, CA 95630 | $30K |
| CA CHARTER SCHOOLS CONFERENCE EIN 51-0465703 MARKETING | Other services Service code 49 | 1277 UNIVERSITY OF OREGON EUGENE, OR 97403 | $27K |
| BRANCHE JONES EIN 57-3276370 CONSULTANT | Consulting (general) Service code 16 | 1127 11TH ST., STE 321 SACRAMENTO, CA 95814 | $25K |
| BUCHALTER EIN 95-2640846 LEGAL | Legal Service code 29 | 1000 WILSHIRE BLVD SUITE 1500 LOS ANGELES, CA 90017 | $19K |
| TRICORD TRADESHOW SERVICES EIN 77-0495477 MERCHANT | Other fees Service code 99 | 738 NEESON ROAD MARINA, CA 93933 | $12K |
| NATASHAY STARR EIN 48-2900736 CONSULTANT | Consulting (general) Service code 16 | 354 KENILWORTH CIRCLE STONE MOUNTAIN, GA 30083 | $12K |
| EXTRA SPACE MANAGEMENT INC EIN 87-0405300 STORAGE | Other fees Service code 99 | 3800 BAYOU WAY SACRAMENTO, CA 95835 | $10K |
| ALCALA CONSULTING, INC. EIN 91-1947256 CONSULTANT | Consulting (general) Service code 16 | PO BOX 845724 LOS ANGELES, CA 90084 | $10K |
| TEAGUE INSURANCE AGENCY, INC EIN 95-3063524 INSURANCE COMPANY | Insurance agents and brokers Service code 22 | 7777 ALVARADO RD. SUITE 515 LA MESA, CA 91942 | $8K |
| AIRWAYS FREIGHT CORPORATION EIN 71-0542327 MERCHANT | Other fees Service code 99 | PO BOX 1888 FAYETTEVILLE, AR 72701 | $5K |
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 | 1,718 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,745 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,037 | $11.3M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 1,111 | $54K |
| Vision | VISION SERVICE PLAN | 719 | $181K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,443 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,443 | — |
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.