| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | BLUE CROSS OF CALIFORNIA | $12K | $0 | $12K | 1.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3310 SANTA BARBARA, CA 93130 | BLUE CROSS OF CALIFORNIA | $11K | $0 | $11K | 1.30% |
| GARY CHRISTOPHER JENNISON3 | 216 GRAND CANAL BALBOA ISLAND, CA 95662 | BLUE CROSS OF CALIFORNIA | $6K | $0 | $6K | 0.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | BLUE CROSS OF CALIFORNIA | $3K | $0 | $3K | 0.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $10 | $12K | 1.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | 11440 TOMAHAWK CREEK PARKWAY LEASWOOD, KS 66211 | KAISER FOUNDATION HEALTH PLAN INC | $11K | $0 | $11K | 1.66% |
| GARY CHRISTOPHER JENNISON3 | 216 GRAND CANAL BALBOA ISLAND, CA 92662 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 1.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | PROMINENCE HEALTH PLAN | $11K | $0 | $11K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 4.63% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.01% |
| GARY CHRISTOPHER JENNISON3 | 216 GRAND CANAL BALBOA ISLAND, CA 95662 | AETNA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 2.25% |
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 | 241 | 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) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 177 | $1.7M |
| Dental | AETNA LIFE INSURANCE COMPANY | 441 | $194K |
| Vision | AETNA LIFE INSURANCE COMPANY | 441 | $194K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 441 | $194K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 177 | $1.7M |
| Other | AETNA LIFE INSURANCE COMPANY | 441 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 441 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.