| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INS. SVCS., LLC3 Filed as: BENEFITS AMERICA INS SVC LLC | 1800 QUAIL ST., STE 110 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS' SERVICE | — | $234K | $234K | 1.76% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | CALIFORNIA PHYSICIANS' SERVICE | — | $217K | $217K | 1.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4371 LATHAM ST., SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | — | $105K | $105K | 0.79% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL ST STE 110 NEWPORT BEACH, CA 926602340 | KAISER FOUNDATION HEALTH PLAN INC | $20K | — | $20K | 2.79% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 0.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 925162158 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $358 | $7K | 0.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SE | PO BOX 255387 SACRAMENTO, CA 95865 | GUARDIAN | $9K | $36K | $45K | 11.56% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL ST #110 NEWPORT BEACH, CA 92660 | GUARDIAN | $2K | — | $2K | 0.59% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | GUARDIAN | $814 | — | $814 | 0.21% |
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 | 934 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 947 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 2,634 | $14.2M |
| Dental | GUARDIAN | 1,308 | $387K |
| Vision | GUARDIAN | 1,308 | $387K |
| Life insurance | GUARDIAN | 1,308 | $387K |
| Long-term disability | GUARDIAN | 1,308 | $387K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 2,634 | $14.2M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 1,308 | $699K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,634 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.