| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | BLUE CROSS OF CALIFORNIA | $118K | — | $118K | 1.67% |
| TOLMAN AND WIKER INS. SVCS., LLC3 Filed as: TOLMAN & WIKER INSURANCE SERVICES | LLC 196 SOUTH FIR STREET VENTURA, CA 93002 | BLUE CROSS OF CALIFORNIA | $112K | — | $112K | 1.58% |
| TOLMAN AND WIKER INS. SVCS., LLC3 Filed as: TOLMAN & WIKER INSURANCE SERVICES | LLC 196 SOUTH FIR ST. VENTURA, CA 93002 | BLUE CROSS OF CALIFORNIA | $226K | — | $226K | 3.62% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 4500 TOWN CENTER BLVD. SUITE 200 JEFFERSONVILLE, IN 47130 | BLUE CROSS OF CALIFORNIA | — | $5K | $5K | 0.08% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DR. P.O. BOX 527 FARMINGTON, CT 06034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $248 | $5K | 5.15% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC | 420 LEXINGTON AVE. SUITE 2220 NEW YORK, NY 10170 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $82 | $1K | 1.40% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - | LOS ANGELES 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $991 | — | $991 | 1.13% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DRIVE FARMINGTON, CT 06034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $719 | $93 | $812 | 0.93% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - NEW YORK | P.O. BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DR. P.O. BOX 527 FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $155 | $3K | 3.79% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DRIVE FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $59 | $2K | 2.83% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC | 420 LEXINGTON AVE. SUITE 2220 NEW YORK, NY 10170 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $54 | $2K | 2.20% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BNEEFITS - | LOS ANGELES 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $624 | — | $624 | 0.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5 | — | $5 | 0.01% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC | 420 LEXINGTON AVENUE SUITE 2220 NEW YORK, NY 10170 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 25.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.28% |
| BUCK GLOBAL LLC3 | P.O. BOX 207640 DALLAS, TX 75320 | METLIFE LEGAL PLANS | $3K | $623 | $4K | 12.87% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY INC. | 1820 EAST 1ST ST. SUITE 400 SANTA ANA, CA 92705 | TRANSAMERICA LIFE INSURANCE COMPANY | $220 | — | $220 | 1.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN. | P.O. BOX 850502 MINNEAPOLIS, MN 55485 | TRANSAMERICA LIFE INSURANCE COMPANY | $172 | — | $172 | 0.78% |
| CESAR V. GOLDMAN3 | 23680 PARK SEVILLA CALABASAS, CA 91302 | TRANSAMERICA LIFE INSURANCE COMPANY | $82 | — | $82 | 0.37% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SEABURY & SMITH INC. | ATTN BOB SHELQUIST P.O. BOX 9282 DES MOINES, IA 50306 | TRANSAMERICA LIFE INSURANCE COMPANY | $60 | — | $60 | 0.27% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | TRANSAMERICA LIFE INSURANCE COMPANY | $46 | — | $46 | 0.21% |
| BUCK GLOBAL LLC3 | P.O. BOX 207640 DALLAS, TX 75320 | METLIFE LEGAL PLANS | $1K | $7 | $1K | 7.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METLIFE LEGAL PLANS | $888 | $39 | $927 | 5.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | HEALTH AND HUMAN RESOURCE CENTER | $2K | — | $2K | 15.00% |
| BUCK GLOBAL LLC3 | P.O. BOX 207640 DALLAS, TX 75320 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 14.83% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DR. P.O. BOX 527 FARMINGTON, CT 06034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $410 | — | $410 | 5.04% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DRIVE FARMINGTON, CT 06034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $272 | $35 | $307 | 3.77% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | LOS ANGELES 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $153 | — | $153 | 1.88% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC | 420 LEXINGTON AVE. SUITE 2220 NEW YORK, NY 10170 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $139 | $10 | $149 | 1.83% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - NEW YORK | P.O. BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DR. P.O. BOX 527 FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $268 | — | $268 | 3.99% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC | 420 LEXINGTON AVE. SUITE 2220 NEW YORK, NY 10170 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $256 | $7 | $263 | 3.91% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 30 WATERSIDE DRIVE FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $171 | $22 | $193 | 2.87% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | LOS ANGELES 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $92 | — | $92 | 1.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19 | — | $19 | 0.28% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - NEW YORK | P.O. BOX 905494 CHARLOTTE, NC 282905494 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $64 | — | $64 | 2.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $135 | — | $135 | 5.57% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - NEW YORK | P.O. BOX 905494 CHARLOTTE, NC 282905494 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 2.57% |
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 | 799 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 802 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS OF CALIFORNIA | 1,604 | $13.3M |
| Dental(2 contracts) | BLUE CROSS OF CALIFORNIA | 1,604 | $13.3M |
| Vision | BLUE CROSS OF CALIFORNIA | 1,604 | $7.1M |
| Life insurance(10 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 1,604 | $13.5M |
| Short-term disability(2 contracts) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 142 | $96K |
| Prescription drug(2 contracts) | BLUE CROSS OF CALIFORNIA | 1,604 | $13.3M |
| Other(12 contracts, 6 carriers) | BLUE CROSS OF CALIFORNIA | 1,604 | $13.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,604 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.