| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN FOLSOM, CA 95630 | CALIFORNIA CHOICE | $44K | $0 | $44K | 3.05% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | UNKNOWN FOLSOM, CA 95630 | CALIFORNIA CHOICE | $31K | $0 | $31K | 2.12% |
| WESTCORP FINANCIAL SERVICES3 | UNKOWN FOLSOM, CA 95630 | CALIFORNIA CHOICE | $28K | $0 | $28K | 1.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | DELTA DENTAL OF CALIFORNIA | $14K | $0 | $14K | 11.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | P.O BOX 803 LOS ALAMOS, CA 93440 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 9.66% |
| WESTCORP FINANCIAL SERVICES3 | 110 BLUE RAVINE ROAD, SUITE 158 FOLSOM, CA 95630 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 6.18% |
| ENROLLEASE3 | 660 YORK STREET, SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 1.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | PRINCIPAL LIFE INSURANCE COMPANY | $254 | $0 | $254 | 7.69% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS., LLC | 2 ENTERPRISE DRIVE, SUITE 204 NO SHELTON, CT 06484 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $138 | $138 | 4.18% |
| ALEXIS NICOLE DEVORSS3 | 110 BLUE RAVINE ROAD, SUITE 158 FOLSOM, CA 95630 | PRINCIPAL LIFE INSURANCE COMPANY | $87 | $37 | $124 | 3.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $37 | $37 | 1.12% |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 100 | $1.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 227 | $120K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 133 | $86K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 133 | $86K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 132 | $3K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 133 | $86K |
| Prescription drug | CALIFORNIA CHOICE | 100 | $1.4M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 133 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.