| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | VISION SERVICE PLAN | $2K | $0 | $2K | 2.80% |
| LOCKTON COMPANIES, LLC3 | 14005 LIVE OAK AVENUE IRWINDALE, CA 91706 | PAN-AMERICAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $1K | $0 | $1K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | 3475 EAST FOOTHILL BOULEVARD SUITE 100 PASADENA, CA 91107 | RELIASTAR LIFE INSURANCE COMPANY | $108 | $0 | $108 | 2.83% |
| JAMES BARRETT3 Filed as: JAMES H BARRETT | 1200 EAST TAFT AVENUE SAPULPA, OK 74066 | RELIASTAR LIFE INSURANCE COMPANY | $34 | $0 | $34 | 0.89% |
| BRIAN SANDERSON3 | 1503 NORTH GRAND OAKS AVENUE PASADENA, CA 91104 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $34 | $0 | $34 | 4.44% |
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 | 1,075 | 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) | 1,075 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 319 | $233K |
| Vision | VISION SERVICE PLAN | 563 | $58K |
| Life insurance(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,075 | $944K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,075 | $902K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,075 | $902K |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,075 | $951K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,075 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.