| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 Filed as: IMA INC. | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $63K | $22 | $63K | 3.70% |
| ASSUREDPARTNERS3 Filed as: UNITED AGENCIES INC. | 100 N. 1ST STREET SUITE 301 BURBANK, CA 91502 | KAISER FOUNDATION HEALTH PLAN INC. | $23K | — | $23K | 1.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 7.44% |
| ASSUREDPARTNERS3 Filed as: UNITED AGENCIES INC. | 100 N. 1ST STREET SUITE 301 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 2.56% |
| ASSUREDPARTNERS3 Filed as: UNITED AGENCIES | 100 N. 1ST STREET SUITE 301 BURBANK, CA 91502 | EYEMED VISION CARE | $1K | — | $1K | 8.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | EYEMED VISION CARE | $78 | — | $78 | 0.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $494 | — | $494 | 7.14% |
| ASSUREDPARTNERS3 Filed as: UNITED AGENCIES INC. | 100 N. 1ST STREET SUITE 301 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $198 | — | $198 | 2.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $302 | — | $302 | 7.08% |
| ASSUREDPARTNERS3 Filed as: UNITED AGENCIES INC. | 100 N. 1ST STREET SUITE 301 BURBANK, CA 91502 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $125 | — | $125 | 2.93% |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 161 | $1.7M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 68 | $65K |
| Vision | EYEMED VISION CARE | 112 | $12K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $4K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 162 | $7K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 161 | $1.7M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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."
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.