| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PACIFIC COAST BENEFITS INSURANCE3 Filed as: PACIFIC COAST BENEFITS INS SERVICES | 7600 MONTEREY STREET, SUITE 140 GILROY, CA 95020 | BLUE CROSS OF CALIFORNIA | $35K | $0 | $35K | 3.09% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | $0 | $23K | $23K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $10K | $0 | $10K | 0.92% |
| PACIFIC COAST BENEFITS INSURANCE3 Filed as: PACIFIC COAST BENEFITS INS SERVICES | PO BOX 1749 GILROY, CA 95021 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $0 | $12K | 7.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 5405 MOREHOUSE DRIVE, SUITE 340 SAN DIEGO, CA 92121 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.35% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 7310 NORTH 16TH STREET, SUITE 226 PHOENIX, AZ 85020 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 2.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS., INC. | 300 NORTH LASALLE STREET 17TH FLOOR CHICAGO, IL 60654 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.76% |
| PACIFIC COAST BENEFITS, LLC3 | PO BOX 1749 GILROY, CA 95021 | VISION SERVICE PROVIDER | $1K | $0 | $1K | 3.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PROVIDER | $277 | $0 | $277 | 0.95% |
| PACIFIC COAST BENEFITS INSURANCE3 Filed as: PACIFIC COAST BENEFITS INS SERVICES | PO BOX 1749 GILROY, CA 95021 | METROPOLITAN LIFE INSURANCE COMPANY | $866 | $0 | $866 | 10.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $263 | $132 | $395 | 4.63% |
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 | 200 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 113 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 329 | $165K |
| Vision | VISION SERVICE PROVIDER | 194 | $29K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 304 | $9K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 113 | $1.1M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 304 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 329 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.