Form 5500 · Employee benefit plan · FOLSOM, CA
CTI III LLC
Public Form 5500 records show how CTI III LLC of FOLSOM, CA, a professional services employer, structures its employee benefits. Its broker of record is HUB INTERNATIONAL INS. SVCS., INC.. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 47-2890879 · plan 501 · as of Aug 2026
Plan brief
Schedule A lists 4 insured contracts covering health, dental, vision, life and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 77 people.
Reported premium across the insured contracts is $1,132,566, with $70,505 in disclosed broker commissions — about 6.2% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
HUB INTERNATIONAL INS. SVCS., INC. is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing — UNITEDHEALTHCARE INSURANCE COMPANY, KAISER FOUNDATION HEALTH PLAN, INC., THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA and UNITEDHEALTHCARE OF CALIFORNIA — with UNITEDHEALTHCARE INSURANCE COMPANY writing the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 77 | December | $714,569 | $35,612 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 35 | December | $258,100 | $18,111 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision, Life, Disability | 87 | December | $146,629 | $16,119 |
| UNITEDHEALTHCARE OF CALIFORNIA | Health | 1 | December | $13,268 | $663 |
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