| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II, INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | CALIFORNIA PHYSICIANS SERVICE | $14K | $46K | $59K | 5.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $12K | $0 | $12K | 6.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $0 | $16K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCES. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $179 | $179 | 0.19% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $1K | $0 | $1K | 3.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 9868 PLANO ROAD DALLAS, TX 75238 | LIFESECURE INSURANCE COMPANY | $858 | $0 | $858 | 2.65% |
| JEFFREY MERWIN3 | 7005 WARDMAN ROAD BALTIMORE, MD 21212 | LIFESECURE INSURANCE COMPANY | $851 | $0 | $851 | 2.63% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $523 | $0 | $523 | 1.62% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $424 | $0 | $424 | 1.31% |
| CAPITAL METRO FINANCIAL SERVICES3 | 7230 LEE DEFOREST DRIVE COLUMBIA, MD 21046 | LIFESECURE INSURANCE COMPANY | $187 | $0 | $187 | 0.58% |
| TELLUS BROKERAGE CONNECTIONS3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $48 | $0 | $48 | 0.15% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT SUITE 600 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $862 | $0 | $862 | 12.70% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUGDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $530 | $0 | $530 | 7.81% |
| CAP STEWART4 | 5701 WALDEN WOODS COURT KNOXVILLE, TN 37921 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $84 | $0 | $84 | 1.24% |
| LYNN R LIONHOOD4 Filed as: LYNN R. LIONHOOD | 10935 BARBS WAY ORLAND PARK, IL 60467 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $35 | $0 | $35 | 0.52% |
| CRUMP LIFE INSURANCE SERVICES3 | 4135 NORTH FRONT STREET HARRISBURG, PA 17110 | LIFESECURE INSURANCE COMPANY | $422 | $0 | $422 | 6.56% |
| THE HASLETT MANAGEMENT GROUP3 | 459 HERNDON PARKWAY HERNDON, VA 20170 | LIFESECURE INSURANCE COMPANY | $236 | $0 | $236 | 3.67% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 1100 REYNOLDS BOULEVARD WINSTON SALEM, NC 27105 | LIFESECURE INSURANCE COMPANY | $196 | $0 | $196 | 3.04% |
| DAVID HILLELSOHN3 | 13317 SCOTSMORE WAY OAK HILL, VA 20171 | LIFESECURE INSURANCE COMPANY | $134 | $0 | $134 | 2.08% |
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 | 203 | 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) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 15 | $97K |
| Dental | DELTA DENTAL OF CALIFORNIA | 537 | $184K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 180 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 203 | $1.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 203 | $163K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 203 | $163K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 15 | $97K |
| Other(5 contracts, 4 carriers) | CALIFORNIA PHYSICIANS SERVICE | 203 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 537 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.