| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | BLUE SHIELD OF CALIFORNIA | $0 | $380 | $380 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 203 NORTH LASALLE STREET 20TH FLOOR CHICAGO, IL 60601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $95 | $95 | 0.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NY 10281 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $2K | $0 | $2K | 25.01% |
| HELEN LOUISE LUDVIGSON4 | 3405 NW 122ND STREET VANCOUVER, WA 98685 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $86 | $0 | $86 | 7.60% |
| DONNA S. KRAMER4 Filed as: DONNA S KRAMER | 4815 HOLDEN DRIVE ROCKLIN, CA 95677 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $35 | $0 | $35 | 3.09% |
| MARIA SCHWARTZ4 | 312 VIA PROMESA SAN CLEMENTE, CA 92673 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $31 | $0 | $31 | 2.74% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 112 | $3.2M |
| Vision | VISION SERVICE PLAN | 101 | $26K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 112 | $53K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 112 | $57K |
| Prescription drug(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 112 | $3.2M |
| Other(5 contracts, 5 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.