| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS OF CALIFORNIA | $9K | $17K | $26K | 0.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | -$287 | $240 | -$47 | -0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | METROPOLITAN LIFE INSURANCE COMPANY | $118K | $108 | $118K | 25.56% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | $0 | $30K | 6.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 1.17% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 2 ENTERPRISE DRIVE, SUITE 204 SHELTON, CT 06484 | METROPOLITAN LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $120K | $0 | $120K | 37.11% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59K | $0 | $59K | 21.25% |
| MICHELLE ANN DERAS3 Filed as: MICHELLE A. DERAS | PO BOX 365 WEST COVINA, CA 91793 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.45% |
| RENEE SUZANNE CORSO3 Filed as: RENEE S. CORSO | 5805 SEPULVEDA BOULEVARD SUITE 740 SHERMAN OAKS, CA 91411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.43% |
| RUBEN ROSA3 | 5805 SEPULVEDA BOULEVARD SUITE 700 SHERMAN OAKS, CA 91411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.36% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOW, RI 02852 | CONTINENTAL AMERICAN INSURANCE COMPANY | $336 | $0 | $336 | 0.12% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | CONTINENTAL AMERICAN INSURANCE COMPANY | $260 | $0 | $260 | 0.09% |
| MJ INSURANCE3 Filed as: PAUL GALLEGOS AND VARIOUS AGENTS | 10519 SHOSHONE AVENUE GRANADA, CA 91344 | CONTINENTAL AMERICAN INSURANCE COMPANY | $184 | $0 | $184 | 0.07% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $126K | $16K | $141K | 52.14% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $535 | $2K | 0.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $845 | $0 | $845 | 0.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $745 | $0 | $745 | 0.27% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $265 | $0 | $265 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $153 | $153 | 0.06% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $91 | $0 | $91 | 7.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $34 | $0 | $34 | 2.74% |
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 | 1,841 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,849 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,875 | $11.7M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 2,875 | $8.6M |
| Vision | BLUE CROSS OF CALIFORNIA | 2,875 | $8.6M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,770 | $595K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,770 | $324K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,770 | $324K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,875 | $11.7M |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,502 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,875 | — |
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.