| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3111 CAMINO DEL RIO N. SUITE 1100 SAN DIEGO, CA 92108 | CALIFORNIA PHYSICIANS' SERVICE | — | $63K | $63K | 1.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $53K | $53K | 1.31% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 3111 CAMINO DEL RIO N. SUITE 1100 SAN DIEGO, CA 92108 | CALIFORNIA PHYSICIANS' SERVICE | — | $156 | $156 | 0.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 750 B ST. SUITE 2400 SAN DIEGO, CA 921012476 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 1.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 1.14% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | P.O. BOX 896620 CHARLOTTE, NC 282896620 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | $6K | $35K | 5.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 2.44% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 750 B ST. SUITE 2400 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 1.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 1.38% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5130 PARKWAY PLAZA BLVD. LOCK BOX 896620 CHARLOTTE, NC 28217 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 5.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 4.97% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5446 THORNWOOD DR. SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 3.53% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5130 PARKWAY PLAZA BLVD. LOCK BOX 896620 CHARLOTTE, NC 28217 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 5.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 4.72% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5446 THORNWOOD DR. SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.24% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5130 PARKWAY PLAZA BLVD. LOCK BOX 896620 CHARLOTTE, NC 28217 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 5.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 4.73% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5446 THORNWOOD DR. SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 2.88% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | P.O. BOX 896620 CHARLOTTE, NC 282896620 | VISION SERVICE PLAN | $2K | — | $2K | 2.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | VISION SERVICE PLAN | $1K | — | $1K | 2.15% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5130 PARKWAY PLAZA BLVD. LOCK BOX 896620 CHARLOTTE, NC 28217 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.02% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5130 PARKWAY PLAZA BLVD. LOCK BOX 896620 CHARLOTTE, NC 28217 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.98% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5446 THORNWOOD DR. SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $798 | — | $798 | 5.24% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5130 PARKWAY PLAZA BLVD. LOCK BOX 896620 CHARLOTTE, NC 28217 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $725 | — | $725 | 4.76% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 5446 THORNWOOD DR. SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $662 | $662 | 4.35% |
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 | 1,031 | 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) | 1,031 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 656 | $5.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,667 | $612K |
| Vision | VISION SERVICE PLAN | 546 | $70K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,018 | $168K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 285 | $127K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 237 | $130K |
| Prescription drug(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 656 | $5.4M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,143 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,667 | — |
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."
No prospect flags tripped on this filing.