| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICES | — | $43K | $43K | 4.81% |
| IMA, INC. | 1550 17TH STREET SUITE 600 DENVER, CO 80202 | CALIFORNIA PHYSICIANS' SERVICES | — | $14K | $14K | 1.63% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $4K | $19K | 17.10% |
| REMMEL SOLUTIONS4 | 1183 SWALLOWTAIL WAY NIPOMO, CA 93444 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $700 | — | $700 | 16.19% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON AND COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $184 | — | $184 | 4.26% |
| TERRANCE J FITCH4 Filed as: TERRANCE J. FITCH | 9256 SVL BOX VICTORVILLE, CA 92395 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $46 | — | $46 | 1.06% |
| DEBRA OTTEN4 Filed as: DEBRA L. OTTEN | 1808 KINGS LAKE BLVD. APT. 104 NAPLES, FL 34112 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $33 | — | $33 | 0.76% |
| SABRINA AUGUST4 | 19011 TIGER TAIL ROAD GRASS VALLEY, CA 95949 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $33 | — | $33 | 0.76% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $25 | — | $25 | 0.58% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICES | 0 | $888K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $110K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $110K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $110K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $110K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICES | 0 | $888K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.