| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSUR. SERV. INC. | 1420 5TH ST. SUITE 1500 SEATTLE, WA 98101 | CIGNA HEALTHCARE OF CALIFORNIA | $12K | — | $12K | 1.31% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSUR. SERV. INC. | 1420 5TH ST. SUITE 1500 SEATTLE, WA 98101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $18K | $21K | $39K | 5.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $14K | — | $14K | 2.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1301 DOVE STREET SUITE 200 NEWPORT BEACH, CA 92660 | UPMC HEALTH PLAN | $5K | — | $5K | 1.55% |
| HENDERSON BROTHERS, INC.3 Filed as: HENDERSON BROTHERS INSURANCE AGENCY | 920 FORT DUQUESNE BLVD. PITTSBURGH, PA 15222 | UPMC HEALTH PLAN | $3K | — | $3K | 0.95% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $5K | — | $5K | 3.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | $382 | — | $382 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | AETNA LIFE INSURANCE CO. | $4K | — | $4K | 4.98% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: DRIVER ALLIANT INSURANCE SERVICES | 9E RIVER PARK PLACE EAST SUITE 310 FRESNO, CA 93720 | AETNA LIFE INSURANCE CO. | $4K | — | $4K | 4.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $839 | — | $839 | 2.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET, FL 6 SAN DIEGO, CA 921018156 | VISION SERVICE PLAN | $780 | — | $780 | 1.92% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE ST., SUITE 200 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 16.82% |
| LAWRENCE A. MANTELL & ASSOCIATES3 | INC. 16055 VENTURA BLVD., SUITE 1100 ENCINO, CA 91436 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $795 | — | $795 | 4.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $270 | — | $270 | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1301 DOVE STREET SUITE 200 NEWPORT BEACH, CA 92660 | UPMC HEALTH PLAN | $73 | — | $73 | 3.01% |
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 | 250 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 408 | $1.9M |
| Dental(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 408 | $818K |
| Vision | VISION SERVICE PLAN | 239 | $41K |
| Life insurance | AETNA LIFE INSURANCE CO. | 250 | $88K |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 250 | $107K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 250 | $88K |
| Prescription drug(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 408 | $975K |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES ('CIGNA') | 408 | $757K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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.