| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN, INC. | $158K | $27 | $158K | 2.43% |
| SHOMER INSURANCE AGENCY3 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | KAISER FOUNDATION HEALTH PLAN, INC. | $90K | $0 | $90K | 1.39% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 0.05% |
| SHOMER INSURANCE AGENCY3 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | $0 | $13K | 2.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | $3 | $10K | 1.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $4K | $24K | 4.95% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $221 | $16K | 3.25% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE ROAD, SUITE 110 PITTSBURGH, PA 15220 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.61% |
| SHOMER INSURANCE AGENCY3 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $253 | $2K | 0.39% |
| SHOMER INSURANCE AGENCY3 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | KAISER FOUNDATION HEALTH PLAN, INC. | $15K | $2K | $17K | 3.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | $3 | $9K | 1.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | SAFEGUARD HEALTH PLANS INC., A CALIFORNIA CORPORATION | $1K | $177 | $1K | 4.29% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | SAFEGUARD HEALTH PLANS INC., A CALIFORNIA CORPORATION | $932 | $0 | $932 | 3.31% |
| SHOMER INSURANCE AGENCY3 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | SAFEGUARD HEALTH PLANS INC., A CALIFORNIA CORPORATION | $274 | $34 | $308 | 1.09% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE ROAD, SUITE 110 PITTSBURGH, PA 15220 | SAFEGUARD HEALTH PLANS INC., A CALIFORNIA CORPORATION | $0 | $148 | $148 | 0.53% |
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 | 1,815 | 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) | 1,815 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 536 | $7.5M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,815 | $514K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,815 | $486K |
| Prescription drug(3 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 536 | $7.5M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,815 | $486K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,815 | — |
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.