| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN INC | $40K | $3 | $40K | 2.33% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | KAISER FOUNDATION HEALTH PLAN INC | $34K | $0 | $34K | 2.03% |
| SWEET & BAKER INS. BROKERS, INC.3 | 44 2ND STREET SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 0.79% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | OXFORD HEALTH INSURANCE, INC | $13K | $0 | $13K | 1.61% |
| SWEET & BAKER INS. BROKERS, INC.3 | 44 2ND STREET SAN FRANCISCO, CA 94105 | OXFORD HEALTH INSURANCE, INC | $11K | $0 | $11K | 1.31% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | OXFORD HEALTH INSURANCE, INC | $0 | $10K | $10K | 1.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | OXFORD HEALTH INSURANCE, INC | $9K | $0 | $9K | 1.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | HEALTH PLAN OF NEVADA | $12K | $0 | $12K | 1.93% |
| SWEET & BAKER INS. BROKERS, INC.3 | 44 2ND STREET SAN FRANCISCO, CA 94105 | UNITED CONCORDIA INSURANCE COMPANY | $19K | $0 | $19K | 6.48% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | UNITED CONCORDIA INSURANCE COMPANY | $10K | $262 | $10K | 3.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $440 | $0 | $440 | 0.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 7.64% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $196 | $1K | 4.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 44 2ND STREET SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $527 | $0 | $527 | 1.65% |
| SWEET & BAKER INS. BROKERS, INC.3 | 44 2ND STREET SAN FRANCISCO, CA 94105 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $856 | $0 | $856 | 6.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $442 | $15 | $457 | 3.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $490 | $0 | $490 | 5.95% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | $417 | $0 | $417 | 5.06% |
| SWEET & BAKER INS. BROKERS, INC.3 | 44 2ND STREET SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $329 | $0 | $329 | 3.99% |
| SWEET & BAKER INS. BROKERS, INC.3 | 44 2ND STREET SAN FRANCISCO, CA 94105 | MANAGED HEALTH NETWORK | $237 | $0 | $237 | 3.29% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 123 MISSION STREET, 26TH FLOOR SAN FRANCISCO, CA 94105 | MANAGED HEALTH NETWORK | $123 | $0 | $123 | 1.71% |
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 | 496 | 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) | 496 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 300 | $3.1M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 623 | $303K |
| Vision | VISION SERVICE PLAN | 300 | $45K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $32K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $32K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $40K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 300 | $3.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 496 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 623 | — |
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.