| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3635 RIVERSIDE PLAZA DRIVE SUITE 300 RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 1.91% |
| RAMBAUGH ONE INS. SOLUTIONS INC3 | 1079 SUNRISE AVNEUE SUITE B, BOX 305 ROSEVILLE, CA 95661 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 15.00% |
| ANDY B GLENN II3 Filed as: ANDY B. GLENN | 4267 BRIGHTON WAY KENNESAW, GA 30144 | CONTINENTAL AMERICAN INSURANCE COMPANY | $505 | $0 | $505 | 1.22% |
| JEANETTE Y DURRANI3 Filed as: JEANETTE Y. DURRANI | 11 SOUTH CENTRAL AVENUE SUITE 2115 PHOENIX, AZ 85004 | CONTINENTAL AMERICAN INSURANCE COMPANY | $420 | $0 | $420 | 1.01% |
| MJ INSURANCE3 Filed as: JACE KUERSTEN & VARIOUS AGENTS | 2251 DOUGLAS BOULEVARD SUITE 110 ROSEVILLE, CA 95661 | CONTINENTAL AMERICAN INSURANCE COMPANY | $202 | $0 | $202 | 0.49% |
| PETER JAMES SARANTIS3 Filed as: PETER J. SARANTIS | 1100 CORPORATE WAY, SUITE 100 FREDERICKSBURG, VA 22401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $196 | $0 | $196 | 0.47% |
| JOHN HOFFMAN3 | 2312 CATHAY WAY SACRAMENTO, CA 95864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $166 | $0 | $166 | 0.40% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 14132 SOUTHEAST FIRCREST COURT PORTLAND, OR 97236 | CONTINENTAL AMERICAN INSURANCE COMPANY | $131 | $0 | $131 | 0.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB | UNKNOWN SACRAMENTO, CA 95838 | CLAREMONT EAP | $175 | $0 | $175 | 1.32% |
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 | 424 | 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) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 424 | $284K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 424 | $326K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 424 | $284K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 439 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 439 | — |
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.