| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BINNEY CHASE AND VAN HORNE3 Filed as: BINNEY CHASE & VAN HORNE INC. | 11 W. DEL MAR BLVD. SUITE 200 PASADENA, CA 91105 | BLUE CROSS OF CALIFORNIA | $39K | — | $39K | 4.60% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AND | FINANCIAL SERVICES LBJ FREEWAY #1100 DALLAS, TX 75244 | BLUE CROSS OF CALIFORNIA | — | $18K | $18K | 2.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | BLUE CROSS OF CALIFORNIA | $7K | — | $7K | 0.81% |
| ARROYO INSURANCE SERVICES / BINNEY3 | CHASE AND VAN HORNE INC. 11 W. DEL MAR BLVD., SUITE 200 PASADENA, CA 911052505 | UNION SECURITY INSURANCE COMPANY | $4K | — | $4K | 4.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNION SECURITY INSURANCE COMPANY | $1K | $110 | $2K | 1.53% |
| BINNEY CHASE AND VAN HORNE3 Filed as: BINNEY CHASE & VAN HORNE INC. | 11 W. DEL MAR BLVD. SUITE 200 PASADENA, CA 91105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 10.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $631 | $36 | $667 | 2.33% |
| BINNEY CHASE AND VAN HORNE3 Filed as: BINNEY CHASE & VAN HORNE INC. | 11 W. DEL MAR BLVD. SUITE 200 PASADENA, CA 91105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 10.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $342 | $17 | $359 | 2.77% |
| ARROYO INSURANCE SERVICES / BINNEY3 | CHASE AND VAN HORNE INC. 11 W. DEL MAR BLVD., SUITE 200 PASADENA, CA 911052505 | UDC DENTAL OF CALIFORNIA, INC. | $702 | — | $702 | 7.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UDC DENTAL OF CALIFORNIA, INC. | $244 | $11 | $255 | 2.69% |
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 | 132 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 124 | $849K |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 120 | $110K |
| Vision | UNION SECURITY INSURANCE COMPANY | 120 | $101K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $42K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $29K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $29K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 124 | $849K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.