| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT PRO INSURANCE SERVICES, INC3 Filed as: BENEFIT PRO INSURANCE SVCS, INC. | 2655 CAMINO DEL RIO NORTH SUITE 370 SAN DIEGO, CA 92108 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $156K | $0 | $156K | 4.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES, LLC | 3475 EAST FOOTHILL BOULEVARD SUITE 100 PASADENA, CA 91107 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $50 | $0 | $50 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | 3475 EAST FOOTHILL BOULEVARD SUITE 100 PASADENA, CA 91107 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| BENEFIT PRO INSURANCE SERVICES, INC3 Filed as: BENEFIT PRO INSURANCE SVCS, INC. | 2655 CAMINO DEL RIO NORTH SUITE 370 SAN DIEGO, CA 92108 | KAISER FOUNDATION HEALTH PLAN, INC. | $52K | $0 | $52K | 4.23% |
| BENEFIT PRO INSURANCE SERVICES, INC3 Filed as: BENEFIT PRO INSURANCE SVCS, INC. | 2655 CAMINO DEL RIO NORTH SUITE 370 SAN DIEGO, CA 92108 | ANTHEM LIFE INSURANCE COMPANY | $9K | $0 | $9K | 8.46% |
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 | 1,310 | 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) | 1,310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 789 | $5.0M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 789 | $3.8M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 789 | $3.8M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 1,310 | $103K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 1,310 | $103K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 1,310 | $103K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 789 | $5.0M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,310 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,310 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.