| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCTON COMPANIES LLC | 444 WEST 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $239 | $239 | 0.00% |
| ROBYN L PIPER3 Filed as: ROBYN LEIGH PIPER | 2300 WEST SAHARA AVE, STE 800 LAS VEGAS, NV 89102 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $239 | $239 | 0.00% |
| PIPER JORDAN HEALTH & BENEFITS3 Filed as: PIPER JORDAN HEALTH & BENEFITS, LLC | P.O. BOX 745025 LOS ANGELES, CA 90084 | HARTFORD LIFE AND ACCIDENT | $188K | $0 | $188K | 7.20% |
| LOCKTON COMPANIES, LLC3 | 6000 FELDWOOD ROAD COLLEGE PARK, GA 30349 | HARTFORD LIFE AND ACCIDENT | $84K | $0 | $84K | 3.22% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | $0 | $33K | $33K | 1.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS OF NV | PO BOX 743171 LOS ANGELES, CA 90074 | HARTFORD LIFE AND ACCIDENT | $0 | $22K | $22K | 0.84% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 0.88% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF CONSULTING, INC. | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $79 | $0 | $79 | 0.02% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 500 W. MONROE STREET SUITE 3400 CHICAGO, CA 60661 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $2K | $420 | $3K | 5.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 12520 HIGH BLUFF DR, SUITE 240 SAN BERNARDINO, CA 92130 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $691 | $0 | $691 | 19.99% |
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 | 4,115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 5 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 786 | $8.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 7,385 | $3.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 7,614 | $393K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 6,238 | $2.6M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 6,238 | $2.6M |
| Prescription drug(7 contracts, 5 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 786 | $8.8M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 7,684 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,684 | — |
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.