| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | — | $14K | $14K | 0.58% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: DRIVER ALLIANT INSURANCE SVCS | 9E RIVER PARK PLACE EAST FRESNO, CA 93720 | AETNA LIFE INSURANCE CO. | $8K | — | $8K | 0.34% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 PASADENA, CA 911098299 | KAISER FOUNDATION HEALTH PLAN, INC. | $367 | — | $367 | 0.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: DRIVER ALLIANT INSURANCE SVCS | 9E RIVER PARK PLACE EAST FRESNO, CA 93720 | AETNA HEALTH, INC. | $3K | — | $3K | 0.56% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $15K | $15K | 8.57% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $13K | $13K | 7.40% |
| COMPSYCH5 Filed as: COMPSYCH 35-3739783 | — | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 2.19% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 PASADENA, CA 911098299 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 3.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | -$3K | — | -$3K | -3.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BLVD PASADENA, CA 91107 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 15.26% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 10.21% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CONTINENTAL AMERICAN INSURANCE COMPANY | $463 | — | $463 | 3.64% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN, LLC | PO BOX 310502 DES MOINES, IA 50331 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.04% |
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 | 464 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 783 | $5.2M |
| Dental | AETNA LIFE INSURANCE CO. | 783 | $2.4M |
| Vision | VISION SERVICE PLAN | 366 | $65K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 956 | $180K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 956 | $180K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 346 | $2.1M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 956 | $193K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 956 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.