| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN O BRONSON CO INC3 Filed as: JOHN O BRONSON CO | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | CALIFORNIA PHYSICIANS' SERVICE | $59K | — | $59K | 3.79% |
| ROGERS BENEFIT GROUP INC4 Filed as: ROGERS BENEFIT GROUP INC. | 6155 ALMADEN EXPRESSWAY #210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS' SERVICE | — | $24K | $24K | 1.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | $19K | — | $19K | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | P.O. BOX MIA MONTEREY, CA 93942 | PREMIER ACCESS INSURANCE COMPANY | $2K | — | $2K | 2.17% |
| JOHN O BRONSON CO INC3 Filed as: JOHN O BRONSON CO | 401 FREMONT STREET SUITE 100 MONTEREY, CA 93940 | PREMIER ACCESS INSURANCE COMPANY | $1K | — | $1K | 1.58% |
| JOHN O BRONSON CO INC3 Filed as: JOHN O BRONSON CO | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $297 | — | $297 | 3.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 4371 LATHAM ST SUITE 101 RIVERSIDE, CA 92501 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $192 | — | $192 | 1.97% |
| ROGERS BENEFIT GROUP INC4 Filed as: ROGERS BENEFIT GROUP | 6155 ALMADEN EXPRESSWAY #210 SAN JOSE, CA 95120 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | — | $119 | $119 | 1.22% |
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 | 206 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 186 | $1.5M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 206 | $85K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 186 | $1.5M |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 134 | $10K |
| Short-term disability | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 134 | $10K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 186 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.