| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $56K | — | $56K | 3.14% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | 2125 YGNACIO VALLEY RD. SUITE 200 WALNUT CREEK, CA 94598 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $35K | $2K | $37K | 2.06% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. | 721 S. PARKER STREET ORANGE, CA 92868 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $35K | $35K | 1.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 3.35% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | 750 THE CITY DR. SUITE 450 ORANGE, CA 928684969 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 2.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 430 E. DOUGLAS AVE. SUITE 400 WICHITA, KS 67202 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.21% |
| FOUNDATION RISK PARTNERS CORP3 | 4634 GULFSTARR DR. DESTIN, FL 32541 | PRINCIPAL LIFE INSURANCE COMPANY | $864 | $326 | $1K | 4.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN BENEFIT ADMIN INC. | 721 S. PARKER STREET ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | $745 | $237 | $982 | 3.76% |
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 | 199 | 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) | 199 | 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 | 298 | $2.0M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 298 | $1.8M |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 323 | $26K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 298 | $1.8M |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 298 | $1.8M |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 298 | $2.0M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 298 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.