| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED HEALTHCARE INSURANCE COMPANY | $300K | — | $300K | 4.07% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | UNITED HEALTHCARE INSURANCE COMPANY | — | $13K | $13K | 0.17% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 5446 THORNWOOD DRIVE, SUITE 200 SAN JOSE, CA 95123 | UNITED HEALTHCARE INSURANCE COMPANY | -$91 | — | -$91 | -0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $174K | — | $174K | 4.65% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 750 B STREET, SUITE 2400 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC. | -$15K | — | -$15K | -0.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED CONCORDIA INSURANCE COMPANY | $50K | $15K | $65K | 5.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 3.63% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 750 B STREET, SUITE 2400 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $18K | — | $18K | 5.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $34K | — | $34K | 13.89% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 750 B STREET, SUITE 2400 SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 1.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | VISION SERVICE PLAN | $20K | — | $20K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $3K | — | $3K | 2.93% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 19100 VON KARMAN, SUITE 920 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | -$60 | — | -$60 | -0.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $529 | — | $529 | 2.05% |
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 | 1,959 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,980 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,332 | $12.0M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 1,480 | $1.2M |
| Vision | VISION SERVICE PLAN | 1,057 | $202K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,959 | $247K |
| Prescription drug(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 772 | $4.6M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,959 | $290K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,959 | — |
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.