| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $32K | — | $32K | 2.44% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 911098299 | KAISER FOUNDATION HEALTH PLAN INC. | $30K | — | $30K | 2.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL - RIVERSIDE | P.O. BOX 2158 RIVERSIDE, CA 92516 | SUTTER HEALTH PLAN | $8K | — | $8K | 2.58% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 N. CALIFORNIA BLVD, SUITE 400 WALNUT CREEK, CA 94596 | SUTTER HEALTH PLAN | $8K | — | $8K | 2.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICEES | P.O. BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 4.09% |
| ACRISURE LLC3 | 2185 N. CALIFORNIA ST., SUITE 400 WALNUT CREEK, CA 94596 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 3.19% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 0.97% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 9 E. RIVER PARK PLACE E., FLOOR 3 FRESNO, CA 937201530 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $45 | $4K | 10.77% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 951610520 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 4.81% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 5444 WESTHEIMER ROAD, SUITE 900 HOUSTON, TX 770565306 | METROPOLITAN LIFE INSURANCE COMPANY | — | $973 | $973 | 2.40% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 951610520 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | — | $44 | $44 | 1.48% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 9 E. RIVER PARK PL E., FLOOR 3 FRESNO, CA 937201530 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $26 | — | $26 | 0.88% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 5444 WESTHEIMER ROAD, SUITE 900 HOUSTON, TX 770565306 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | — | $13 | $13 | 0.44% |
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 | 220 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 172 | $1.6M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 370 | $173K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $41K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $41K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 172 | $1.6M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.