| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST. STE 2400 SAN FRANCISCO, CA 941042215 | KAISER PERMANENTE | $13K | — | $13K | 3.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASEDENA, CA 911026030 | KAISER PERMANENTE | $309 | — | $309 | 0.08% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CTR | 1390 WILLOW PASS RD STE 800 CONCORD, CA 94520 | CIGNA HEALTHCARE OF CALIFORNIA | $9K | — | $9K | 3.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD PASADENA, CA 91107 | CIGNA HEALTHCARE OF CALIFORNIA | $24 | — | $24 | 0.01% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CENTER (EPIC) | 1390 WILLOW PASS RD. CONCORD, CA 94520 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 5.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD PASADENA, CA 91107 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $48 | $6K | $6K | 3.88% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC | WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | $1K | $5K | 21.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $91 | $2K | 11.49% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CENTER | PO BOX 5003 SAN RAMON, CA 945830803 | METROPOLITAN LIFE INSURANCE COMPANY | $410 | — | $410 | 2.85% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CENTER | PO BX 511398 LOS ANGELES, CA 900517953 | METROPOLITAN LIFE INSURANCE COMPANY | — | $34 | $34 | 0.24% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 731250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $16K | — | $16K | 13436.13% |
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 | 992 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 992 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER PERMANENTE | 729 | $795K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 729 | $166K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 729 | $166K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 992 | $38K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 168 | $23K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 54 | $119 |
| Prescription drug(3 contracts, 3 carriers) | KAISER PERMANENTE | 729 | $795K |
| Other(3 contracts, 3 carriers) | AFLAC | 992 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 992 | — |
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.