| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE INC3 Filed as: RELATION INS. SVCS. OF CALI | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 6.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | P O BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 3.42% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SVCS. OF CA, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | P O BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.17% |
| OPTAVISE, LLC3 | P O BOX 360422 PITTSBURGH, PA 15251 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 5375 MIRA SORRENTO PLACE, SUITE 400 SAN DIEGO, CA 92121 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 19.17% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SVCS. OF CALI | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | HUMANA INSURANCE COMPANY | $428 | $0 | $428 | 4.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | HUMANA INSURANCE COMPANY | $404 | $0 | $404 | 4.13% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP, INC. | 5110 NORTH 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | HUMANA INSURANCE COMPANY | $232 | — | $232 | 2.37% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SVCS. OF CALI | 4317 NORTH STAR WAY, SUITE A MODESTO, CA 95356 | HUMANA INSURANCE COMPANY | $228 | $0 | $228 | 2.33% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $93K |
| Vision | HUMANA INSURANCE COMPANY | 92 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $123K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $123K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $123K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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.