| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $169K | $3K | $173K | 4.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | SUTTER HEALTH PLAN | $33K | — | $33K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $79 | $11K | 3.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC. | $3K | — | $3K | 9.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $39 | $6K | 17.85% |
| DIANE MARIE SOMMERS3 | 1100 PACIFIC MARINA ALAMEDA, CA 94501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $273 | — | $273 | 1.12% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $269 | — | $269 | 1.10% |
| MICHAEL KEITH MCDONOUGH3 | 1100 PACIFIC MARINA ALAMEDA, CA 94501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $243 | — | $243 | 1.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | $21 | $164 | 0.67% |
| CATHERINE LISA LUKE3 | 4787 W. HACIENDA AVENUE CAMPBELL, CA 95008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $139 | — | $139 | 0.57% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH STREET SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 0.32% |
| CHRISTINA ALTOMARE ESTRADA3 | 1692 CRESCENT DRIVE WALNUT CREEK, CA 94598 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | $1 | $73 | 0.30% |
| ESTRADA ENTERPRISES LLC3 | 1692 CRESCENT DRIVE WALNUT CREEK, CA 94598 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.22% |
| MICHAEL KIRKPATRICK3 | P.O. BOX 270 FREESOM, CA 95050 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.07% |
| ABRAMS MARKETING INC3 Filed as: ABRAMS MARKETING INC. | 9538 W. PICO BLVD. LOS ANGELES, CA 90035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $1 | $13 | 0.05% |
| THE AGURS GROUP INC.4 | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $53 | — | $53 | 16.11% |
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 | 341 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 479 | $4.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $364K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $327K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $351K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 18 | $24K |
| Prescription drug | SUTTER HEALTH PLAN | 126 | $660K |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $386K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 672 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.