| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERCARE INSURANCE SOLUTIONS, INC.3 | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $114K | — | $114K | 11.16% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON INSURANCE SERVICES, LLC | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $24K | — | $24K | 2.32% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $695 | $13K | 8.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $372 | $372 | 0.24% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 5.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $432 | $432 | 0.30% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $2K | — | $2K | 2.59% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON INSURANCE SERVICES, LLC | DEPARTMENT LA 23940 PASADENA, CA 91185 | VISION SERVICE PLAN | $257 | — | $257 | 0.33% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON INSURANCE SERVICES, LLC | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | SIMNSA | $5K | — | $5K | 7.00% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 | 5375 MIRA SORRENTO PLACE, SUITE 400 SAN DIEGO, CA 92121 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 10.39% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 | PO BOX 2158 RIVERSIDE, CA 92516 | CIGNA HEALTHCARE OF CALIFORNIA | $5K | — | $5K | 19.20% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON INSURANCE SERVICES, LLC | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | CIGNA HEALTHCARE OF CALIFORNIA | $992 | — | $992 | 4.05% |
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 | 794 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 798 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,068 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,068 | $1.0M |
| Vision | VISION SERVICE PLAN | 394 | $77K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 767 | $202K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 444 | $146K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,068 | $1.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 767 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,068 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.