| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS, INC | 4812 BROWNDEER LN. RANCHO PALOS VERDES, CA 902753916 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | — | $22K | 4.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $1 | $4K | 0.83% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS, INC | 4812 BROWNDEER LN. RANCHO PALOS VERDES, CA 90275 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 3.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $872 | $1 | $873 | 0.92% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS INC. | 655 DEEP VALLEY DRIVE SUITE 325A ROLLING HILLS ESTATES, CA 902743615 | AMERITAS LIFE INSURANCE CORP. | $4K | $90 | $4K | 10.23% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS | 27520 HAWTHORNE BLVD. SUITE 100 ROLLING HILLS ESTATE, CA 90274 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 9.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $826 | — | $826 | 3.27% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS | 27520 HAWTHORNE BLVD. SUITE 100 ROLLING HILLS ESTATES, CA 90274 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | $1K | — | $1K | 10.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | $13 | — | $13 | 0.11% |
| MONTE TENEYCK3 | 185 PENDLETON LANE TENPLETON, CA 93465 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 3.51% |
| SHANIKA M. FISKE3 | 15 TUOLUMNE WAY ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 3.51% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 1.00% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST. NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.76% |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 149 | $634K |
| Dental(3 contracts, 3 carriers) | AMERITAS LIFE INSURANCE CORP. | 257 | $76K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 257 | $65K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 257 | $25K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 1 | $2K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 257 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.