| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $19K | $1K | $20K | 3.13% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $15K | — | $15K | 2.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | $578 | $13K | 3.04% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | — | $8K | 1.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $2K | $7K | 11.27% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $931 | $5K | 7.52% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.69% |
| DESSO FORMAN3 | 28059 US HWY 19N CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $37 | $6K | 38.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $161 | $2K | 12.09% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $991 | — | $991 | 6.60% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $696 | $148 | $844 | 5.62% |
| DESSO FORMAN3 | 28059 US HWY 19N CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $144 | $3K | 34.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $161 | $1K | 13.40% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $572 | $146 | $718 | 7.97% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $274 | — | $274 | 3.04% |
| DESSO FORMAN3 | 28059 US HWY 19N CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $74 | $3K | 37.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $869 | $161 | $1K | 13.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $395 | $97 | $492 | 6.68% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $370 | — | $370 | 5.02% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 114 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 142 | $63K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 142 | $63K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 142 | $63K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 114 | $1.1M |
| Other(4 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 142 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.