| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST, LLC | 6200 CANOGA AVENUE, SUITE 325 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $43K | $0 | $43K | 2.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $27K | $1 | $27K | 1.24% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER C. FOY AND ASSOCIATES | 6200 CANOGA AVENUE, SUITE 325 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $0 | $22K | 12.23% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | 19000 MACARTHUR BOULEVARD PENTHOUSE FLOOR IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 1.28% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER C. FOY AND ASSOC. INC. SVCES. | UNKNOWN WOODLAND HILLS, CA 91367 | UNITED CONCORDIA INSURANCE COMPANY | $10K | $0 | $10K | 5.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITED CONCORDIA INSURANCE COMPANY | $7K | $3K | $10K | 5.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | $0 | $6K | 11.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $871 | $350 | $1K | 5.82% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER C. FOY AND ASSOC. INC. SVCES. | UNKNOWN WOODLAND HILLS, CA 91367 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $1K | $0 | $1K | 5.78% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER C. FOY AND ASSOC. INC. SVCES. | 6200 CANOGA AVENUE, SUITE 325 WOODLAND HILLS, CA 91367 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $380 | $2K | 8.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $588 | $0 | $588 | 3.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $44 | $44 | 0.24% |
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 | 329 | 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) | 333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 343 | $2.2M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 310 | $193K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 285 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 309 | $182K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 309 | $182K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 309 | $182K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 343 | $2.2M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 309 | $182K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 343 | — |
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.