| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN INC. | $43K | — | $43K | 3.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | GUARDIAN | $13K | — | $13K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.89% |
| COMPSYCH3 | 455 N CITYFRONT PLAZA DR, 13TH FL CHICAGO, IL 60611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 5.40% |
| AXA ASSISTANCE, USA3 | 122 S. MICHIGAN AVENUE CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $110 | $110 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $49 | — | $49 | 0.11% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $7K | $764 | $7K | 18.59% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL - SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $26 | $2K | 6.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | EYEMED VISION CARE | $2K | — | $2K | 10.08% |
| FLEXVISION - MD3 | 15400 CALHOUN DRIVE ROCKVILLE, MD 20855 | EYEMED VISION CARE | — | $251 | $251 | 1.51% |
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 | 306 | 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) | 306 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 204 | $1.3M |
| Dental | GUARDIAN | 217 | $129K |
| Vision | EYEMED VISION CARE | 205 | $17K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 306 | $174K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 204 | $1.3M |
| Other(4 contracts, 4 carriers) | GUARDIAN | 306 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 306 | — |
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."
No prospect flags tripped on this filing.