| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, STE 200 ROSEVILLE, CA 95678 | CALIFORNIA PHYSICIANS SERVICE | $154K | $111 | $154K | 5.04% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, STE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $122K | — | $122K | 5.30% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | DELTA DENTAL OF CALIFORNIA | $20K | — | $20K | 3.38% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED HEALTHCARE INSURANCE COMPANY | $15K | — | $15K | 3.03% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | UNITED HEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 1.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 0.30% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 3.86% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 3636 AMERICAN RIVER DR, 2ND FLOOR SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 0.48% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY | $8K | — | $8K | 3.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY | $1K | — | $1K | 0.44% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, STE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY | $16K | — | $16K | 11.99% |
| DPG CONSULTING INC.3 | 18248 JUSTICE WAY LAKEVILLE, MN 55044 | UNION SECURITY INSURANCE COMPANY | $5K | — | $5K | 3.59% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, STE 200 ROSEVILLE, CA 95678 | VISION SERVICE PLAN | $3K | — | $3K | 2.40% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, STE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY | $9K | — | $9K | 16.77% |
| DPG CONSULTING INC.3 | 18248 JUSTICE WAY LAKEVILLE, CA 55044 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 4.09% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, STE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY | $8K | — | $8K | 16.13% |
| DPG CONSULTING INC.3 | 18248 JUSTICE WAY LAKEVILLE, MN 55044 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 4.14% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, STE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY | $7K | — | $7K | 14.19% |
| DPG CONSULTING INC.3 | 18248 JUSTICE WAY LAKEVILLE, MN 55044 | UNION SECURITY INSURANCE COMPANY | $1K | — | $1K | 3.14% |
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 | 1,129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | CALIFORNIA PHYSICIANS SERVICE | 519 | $6.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 920 | $603K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 690 | $133K |
| Life insurance(2 contracts) | UNION SECURITY INSURANCE COMPANY | 1,129 | $379K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 192 | $52K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 1,129 | $242K |
| Prescription drug(5 contracts, 4 carriers) | CALIFORNIA PHYSICIANS SERVICE | 519 | $6.1M |
| Other(3 contracts) | UNION SECURITY INSURANCE COMPANY | 1,129 | $338K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,129 | — |
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.