| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVENUE RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $272K | $0 | $272K | 4.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | $0 | $2K | 0.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNAITONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | $0 | $23K | 11.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD 14TH FLOOR, SUITE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $10K | $10K | 5.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVENUE RIVERSIDE, CA 92501 | AETNA HEALTH, INC. | $4K | $0 | $4K | 3.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNAITONAL INS SERVICES, INC | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | PAN AMERICAN LIFE INSURANCE COMPANY | $300 | $0 | $300 | 0.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVENUE RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 22.04% |
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 | 336 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 350 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 799 | $7.0M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 799 | $6.4M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 799 | $6.4M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 336 | $212K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 336 | $201K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 336 | $201K |
| Prescription drug(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 799 | $6.9M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 336 | $297K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 799 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.