| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4371 LATHAM ST. SUITE 101 RIVERSIDE, CA 92501 | BLUE SHIELD OF CALIFORNIA | $24K | — | $24K | 2.98% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | BLUE SHIELD OF CALIFORNIA | $23K | — | $23K | 2.83% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD. SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA | $10K | — | $10K | 1.21% |
| JOHNANNA HAAS3 | 1285 W. SHAW AVE. FRESNO, CA 93711 | AFLAC | $8K | $213 | $8K | 11.19% |
| ILIC-STONE INS SERVICES INC3 Filed as: ILIC-STONE INS SERVICES, INC. | 1285 W SHAW AVE. FRESNO, CA 93711 | AFLAC | $2K | $41 | $2K | 2.27% |
| MARISOL MENDOZA3 | 1285 W SHAW AVE. SUITE 101 FRESNO, CA 93711 | AFLAC | $2K | — | $2K | 2.27% |
| LORELEI A ZENTMYER3 | 750 W ALLUVIAL AVE. APT. 1066 CLOVIS, CA 93611 | AFLAC | $1K | $33 | $1K | 1.41% |
| JOSEPH LINVILLE3 | 1285 W SHAW AVE. SUITE 101 FRESNO, CA 93711 | AFLAC | $656 | — | $656 | 0.88% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DR. SUITE 200 ROSEVILLE, CA 95678 | AFLAC | $599 | — | $599 | 0.81% |
| REBECCA A ROBINSON3 | 7302 W PORTAL AVE. FRESNO, CA 93723 | AFLAC | $394 | — | $394 | 0.53% |
| KIMBERLEY LYNN SCHMALL3 Filed as: KIMBERLEY L SCHMALL | 9925 N GRANVILLE AVE. FRESNO, CA 93720 | AFLAC | $225 | — | $225 | 0.30% |
| JOHN L WENDER INSURANCE SERVICES3 Filed as: JOHN M ZENTMYER | 750 W ALLUVIAL AVE. APT. 1066 CLOVIS, CA 93611 | AFLAC | $222 | — | $222 | 0.30% |
| ROBERT WILKINS3 Filed as: ROBERT D WILKINS | 702 YAKIMA ST. S VALE, OR 97918 | AFLAC | $169 | — | $169 | 0.23% |
| CHARLES EDWARD PERRY3 | 12858 TORREY PINES DR. AUBURN, CA 95602 | AFLAC | $103 | — | $103 | 0.14% |
| RHONDA V PHILLIPS3 | 1334 W DAYTON AVE. FRESNO, CA 93705 | AFLAC | $55 | — | $55 | 0.07% |
| ANA PATRICIA ARRIAGA3 | 1115 GRAY AVE. YUBA CITY, CA 95991 | AFLAC | $33 | — | $33 | 0.04% |
| BRENDA S HAMILTON3 Filed as: BRENDA HAMILTON | 37 BIRCH AVE. CLOVIS, CA 93611 | AFLAC | $30 | — | $30 | 0.04% |
| GARY LOWE3 | 13106 NANTUCKET PL BAKERSFIELD, CA 93314 | AFLAC | $29 | — | $29 | 0.04% |
| D BREDESON INSURANCE SERVICES INC3 Filed as: D BREDESON INSURANCE SERVICES INC. | 888 DUGAN DR. PISMO BEACH, CA 93449 | AFLAC | $27 | — | $27 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC. | 2393 TOWNSGATE RD STE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $15 | — | $15 | 0.02% |
| MARICELA SANCHEZ3 | 509 E BROWNING AVE. HERMISTON, OR 97838 | AFLAC | $10 | — | $10 | 0.01% |
| STACIE L BENDER3 | 2406 WINDERMERE ST. BAKERSFIELD, CA 93311 | AFLAC | $10 | — | $10 | 0.01% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $8 | — | $8 | 0.01% |
| DUANNE ANDREW FRY3 | 641 HIGUERA ST. SUITE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $6 | — | $6 | 0.01% |
| BANZAI INSURANCE SOLUTIONS INC3 Filed as: BANZAI INSURANCE SOLUTIONS, INC. | 9209 COLBERG DR. AUSTIN, TX 78749 | AFLAC | $3 | — | $3 | 0.00% |
| DENA JORDAN3 Filed as: DENA L JORDAN | 641 HIGUERA ST. SUITE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES, INC. | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN, INC. | $641 | — | $641 | 4.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN, INC. | — | $20 | $20 | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SE | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 12.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SE | 4371 LATHAM ST. SUITE #101 RIVERSIDE, CA 92501 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 11.76% |
| WILLNER-CARDINET-KIDWELL3 | 333 N INDIAN HILL BLVD. CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $28 | — | $28 | 0.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4371 LATHAM ST. SUITE 101 RIVERSIDE, CA 92501 | BLUE SHIELD OF CALIFORNIA | $130 | — | $130 | 2.92% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | BLUE SHIELD OF CALIFORNIA | $129 | — | $129 | 2.90% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD. SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA | $89 | — | $89 | 2.00% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 68 | $824K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 91 | $9K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 91 | $9K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 111 | $79K |
| Short-term disability | AFLAC | 48 | $74K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 68 | $824K |
| Other | BLUE SHIELD OF CALIFORNIA | 111 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.