| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $49K | — | $49K | 5.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE | 6200 CANOGA AVENUE SUITE 300 WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS' SERVICE | $12K | — | $12K | 1.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 6.64% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 3.80% |
| IMA, INC.3 Filed as: IMA INC. | 430 E. DOUGLAS STREET SUITE 400 WICHITA, KS 67202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.76% |
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 | 216 | 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) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 187 | $988K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 217 | $183K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 217 | $183K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 217 | $183K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 217 | $183K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 187 | $988K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 217 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.