| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC. | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $24K | $0 | $24K | 1.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $0 | $16K | 0.68% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC. | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | REGENCE BLUESHIELD | $14K | $0 | $14K | 2.50% |
| DARREN D. CAESAR3 | PO BOX 4047 CONCORD, CA 94524 | REGENCE BLUESHIELD | $12K | $0 | $12K | 2.11% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC. | 2033 MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | $0 | $14K | 5.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3000 EXECUTIVE PARKWAY, SUITE 300 SAN RAMON, CA 94583 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | $0 | $9K | 3.38% |
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 | 470 | 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) | 470 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 390 | $3.0M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 316 | $270K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 316 | $270K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 316 | $270K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 390 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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.