| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | BLUE CROSS OF CALIFORNIA | $65K | $0 | $65K | 0.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE RIVERSIDE, CA 92516 | BLUE CROSS OF CALIFORNIA | -$33K | $9K | -$25K | -0.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $0 | $5K | $5K | 0.30% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | $0 | $3K | 0.19% |
| STEVEN RAY GRIFFIN3 Filed as: STEVEN GRIFFIN | 2000 MORRIS AVENUE, APARTMENT 1400 BIRMINGHAM, AL 35203 | METROPOLITAN LIFE INSURANCE COMPANY | $120K | $0 | $120K | 27.53% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | ONE ENTERPRISE DRIVE, SUITE 210 SHELTON, CT 06484 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $1K | $21K | 4.89% |
| COMPLETE BENEFIT ALLIANCE3 | 2000 MORRIS AVENUE APARTMENT 1400 BIRMINGHAM, AL 35203 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $96 | $96 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | -$568 | -$568 | -0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 6701 CENTER DRIVE WEST SUITE 1500 LOS ANGELES, CA 90045 | METROPOLITAN LIFE INSURANCE COMPANY | -$5K | $160 | -$5K | -1.11% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOW, RI 02852 | CONTINENTAL AMERICAN INSURANCE COMPANY | $54K | $0 | $54K | 19.25% |
| STEVEN RAY GRIFFIN3 Filed as: STEVEN R. GRIFFIN | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $39K | $0 | $39K | 13.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 6701 CENTER DRIVE WEST SUITE 1500 LOS ANGELES, CA 90045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 2.27% |
| MICHELLE ANN DERAS3 Filed as: MICHELLE A. DERAS | PO BOX 365 WEST COVINA, CA 91793 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 0.78% |
| RENEE SUZANNE CORSO3 Filed as: RENEE S. CORSO | 5805 SEPULVEDA BOULEVARD, SUITE 740 SHERMAN OAKS, CA 91411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 0.75% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.36% |
| MJ INSURANCE3 Filed as: PAUL GALLEGOS AND VARIOUS AGENTS | 10519 SHOSHONE AVENUE GRANADA, CA 91344 | CONTINENTAL AMERICAN INSURANCE COMPANY | $729 | $0 | $729 | 0.26% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, APARTMENT 1400 BIRMINGHAM, AL 35203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $35K | $0 | $35K | 13.69% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $81K | $10K | $91K | 36.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $0 | $8K | 3.15% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $1K | $8K | 3.04% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $119 | $0 | $119 | 7.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $46 | $0 | $46 | 2.79% |
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 | 1,971 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,972 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 3,387 | $12.1M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 3,387 | $8.7M |
| Vision | BLUE CROSS OF CALIFORNIA | 3,387 | $8.7M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,957 | $505K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,957 | $254K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 10 | $1K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 3,387 | $12.1M |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,397 | $968K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,387 | — |
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.