| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4371 LATHAM STREET RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $21K | $293 | $21K | 5.08% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS | P.O. BOX 2158 RIVERSIDE, CA 92516 | BLUE CROSS OF CALIFORNIA | — | $315 | $315 | 0.08% |
| TAPERT INSURANCE AGENCY3 Filed as: TAPERT INSURANCE AGENCY, INC. | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 91024 | AETNA LIFE INSURANCE COMPANY | $22K | — | $22K | 5.49% |
| TAPERT INSURANCE AGENCY3 Filed as: TAPERT INSURANCE AGENCY, INC. | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 91024 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $7K | — | $7K | 14.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | EYEMED VISION CARE | $869 | — | $869 | 10.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | CALIFORNIA DENTAL NETWORK, INC. | $313 | — | $313 | 10.00% |
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 | 239 | 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) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 52 | $823K |
| Dental | CALIFORNIA DENTAL NETWORK, INC. | 13 | $3K |
| Vision | EYEMED VISION CARE | 119 | $9K |
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 239 | $51K |
| Short-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 239 | $51K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 239 | $51K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 14 | $414K |
| Other | AMERICAN GENERAL LIFE INSURANCE COMPANY | 239 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.