| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN, INC. | $44K | $0 | $44K | 1.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | $0 | $28K | 0.95% |
| ALLIANT INSURANCE SERVICES, INC.3 | 9E RIVER PARK PLACE EAST FRESNO, CA 93720 | AETNA HEALTH, INC. | $63K | — | $63K | 2.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS. INC. | 9855 SCRANTON ROAD SAN DIEGO, CA 92121 | AETNA HEALTH, INC. | $25K | $12K | $37K | 1.30% |
| ALLIANT INSURANCE SERVICES, INC.3 | 9E RIVER PARK PLACE EAST FRESNO, CA 93720 | AETNA LIFE INSURANCE COMPANY | $23K | $0 | $23K | 2.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS. INC. | 9855 SCRANTON ROAD SAN DIEGO, CA 92121 | AETNA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 0.77% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD SUITE 400 WALNUT CREEK, CA 94596 | PRINCIPAL LIFE INSURANCE COMPANY | $56K | — | $56K | 9.33% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | — | $53K | $53K | 8.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 9855 SCRANTON ROAD, SUITE 100 RIVERSIDE, CA 92121 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | $0 | $15K | 2.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $7K | $7K | 1.12% |
| EBIS3 | 9625 MISSION GORGE ROAD SUITE B2, 304 SANTEE, CA 92071 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $48K | $2K | $51K | 18.25% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD SUITE 400 WALNUT CREEK, CA 94596 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | $10K | $19K | 6.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 1.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB IINTERNATIONAL MIDWEST LIMITED | 3510 NORTH CAUSEWAY BOULEVARD METAIRIE, LA 70002 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $489 | $489 | 0.18% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD SUITE 400 WALNUT CREEK, CA 94596 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $530 | $0 | $530 | 10.00% |
| MARK S METTILLE3 Filed as: MARK STEPHEN METTILLE | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $265 | — | $265 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN INC | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $212 | — | $212 | 4.00% |
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 | 1,237 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 52 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 454 | $6.9M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,514 | $600K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 1,514 | $595K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,514 | $595K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 10 | $278K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 10 | $278K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 454 | $6.9M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,514 | $874K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,514 | — |
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.