| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | CALIFORNIA PHYSICIANS SERVICE | $30K | $6K | $35K | 4.02% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | CALIFORNIA PHYSICIANS SERVICE | $14K | — | $14K | 1.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | GUARDIAN | $12K | $4K | $16K | 9.54% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | GUARDIAN | $5K | — | $5K | 3.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $254 | $4K | 3.89% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 1.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $273 | $4K | 3.84% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 1.01% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 16.39% |
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 | 166 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 98 | $1.1M |
| Dental | GUARDIAN | 166 | $167K |
| Vision | GUARDIAN | 166 | $167K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 166 | $213K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 166 | $213K |
| Long-term disability | GUARDIAN | 166 | $167K |
| Prescription drug(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 98 | $1.1M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 166 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.