| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CAL INS. SVCES | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $22K | $0 | $22K | 3.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCH CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $0 | $14K | 2.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92516 | WESTERN HEALTH ADVANTAGE | $7K | $0 | $7K | 3.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCH CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE | $4K | $0 | $4K | 1.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | DELTA DENTAL OF CALIFORNIA | $7K | $0 | $7K | 7.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN SACRAMENTO, CA 95841 | DELTA DENTAL OF CALIFORNIA | $2K | $0 | $2K | 2.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 11.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 11060 WHITE ROCK ROAD, SUITE 160 RANCH CORDOVA, CA 95670 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $852 | $0 | $852 | 6.00% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI AND ASSOC. INS. SVCS. | 3400 WEST MINERAL KING, SUITE B VISALIA, CA 93291 | AMERICAN FIDELITY ASSURANCE COMPANY | $170 | $0 | $170 | 6.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | AMERICAN FIDELITY ASSURANCE COMPANY | $57 | $0 | $57 | 2.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, FL 60008 | AMERICAN FIDELITY ASSURANCE COMPANY | $43 | $0 | $43 | 1.76% |
| TANIA N. BROOKSBY3 | 6400 ORANGE HILL LANE CARMICHAEL, CA 95608 | AMERICAN FIDELITY ASSURANCE COMPANY | $24 | $0 | $24 | 0.98% |
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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 98 | $881K |
| Dental | DELTA DENTAL OF CALIFORNIA | 181 | $89K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 76 | $14K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 173 | $57K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 173 | $57K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 173 | $57K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 98 | $881K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 173 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.