| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 NORTH GLENOAKS BOULEVARD SUITE 410 BURBANK, CA 91502 | KAISER FOUNDATION HEALTH PLAN INC | $42K | $0 | $42K | 4.22% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 0.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 8.27% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 3 PARKWAY NORTH, SUITE 500 DEERFIELD, IL 60015 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 5.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.73% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $24 | $24 | 0.04% |
| BRANDON TYLOR-DA SHIRLEY3 | 5110 SOUTH SHERBOURNE DRIVE LOS ANGELES, CA 90056 | AFLAC | $2K | $174 | $2K | 6.95% |
| BRANDON TYLOR-DA SHIRLEY3 | 5211 PACIFIC CONCOURSE DRIVE APARTMENT 1254 LOS ANGELES, CA 90045 | AFLAC | $1K | $0 | $1K | 4.17% |
| MYKISHA L. THOMAS3 Filed as: MYKISHA L. BUTLER | 3886 3RD AVENUE LOS ANGELES, CA 90008 | AFLAC | $1K | $7 | $1K | 3.61% |
| DAVID HERNANDEZ3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $539 | $42 | $581 | 2.02% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $104 | $0 | $104 | 0.36% |
| JASMINE SALAZAR3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $85 | $0 | $85 | 0.29% |
| STEVEN R. JOHNSON3 | 2239 WEST 19TH STREET TORRANCE, CA 90504 | AFLAC | $73 | $0 | $73 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 NORTH GLENOAKS BOULEVARD SUITE 410 BURBANK, CA 91502 | HUMANA INSURANCE COMPANY | $874 | $0 | $874 | 9.10% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE ROAD PITTSBURGH, PA 15220 | HUMANA INSURANCE COMPANY | $0 | $407 | $407 | 4.24% |
| USI INSURANCE SERVICES LLC3 | 333 SOUTH GRAND AVENUE SUITE 1450 LOS ANGELES, CA 90071 | HUMANA INSURANCE COMPANY | $84 | $0 | $84 | 0.87% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 127 | $1.0M |
| Vision | HUMANA INSURANCE COMPANY | 96 | $10K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $62K |
| Short-term disability | AFLAC | 23 | $29K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $62K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 127 | $1.0M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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."
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.