| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | $126 | $138K | $138K | 3.71% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CALIFORNIA PHYSICIANS' SERVICE | $54 | $62K | $62K | 1.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $32K | $0 | $32K | 2.87% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $22K | $0 | $22K | 1.92% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $294 | $294 | 0.03% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $261 | $16K | 2.92% |
| PLANSOURCE BENEFITS ADMINISTRATION5 Filed as: PLANSOURCE BENEFITS ADMIN. INC. | 101 SOUTH GARLAND AVENUE SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $16K | $16K | 2.92% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, CA 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7K | $7K | 1.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $177 | $177 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.45% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23940 PASADENA, CA 91185 | VISION SERVICE PLAN | $424 | $0 | $424 | 1.06% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INSURANCE AGENCIES, INC. | 90 MAIN STREET BATAVIA, NY 14020 | SHELTERPOINT LIFE INSURANCE COMPANY | $354 | $0 | $354 | 15.40% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 480 | $4.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 655 | $556K |
| Vision | VISION SERVICE PLAN | 277 | $40K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 655 | $556K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 655 | $558K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 655 | $556K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 480 | $4.8M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 655 | $556K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 655 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.