| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $23K | $3K | $26K | 3.22% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | $0 | $15K | $15K | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3635 RIVERSIDE PLAZA DRIVE BUILIDING M3 SUITE 320 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE CO | $4K | $0 | $4K | 2.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | HUMANA EMPLOYERS HEALTH PLAN | $5K | $0 | $5K | 2.78% |
| LANDMARK BENEFITS INC3 Filed as: LANDMARK INSURANCE LLC | 5388 EAST MOUNTAIN STREET STONE MOUNTAIN, GA 30083 | HUMANA EMPLOYERS HEALTH PLAN | $2K | $399 | $2K | 1.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE CO | $5K | $1K | $6K | 7.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 2375 EAST CAMELBACK ROAD PHOENIX, AZ 85016 | DELTA DENTAL OF ARKANSAS | $2K | $0 | $2K | 10.00% |
| MJ INSURANCE3 Filed as: STACI FERRARIS AND VARIOUS AGENTS | 28912 GLEN ROCK PLACE HIGHLAND, CA 92346 | COLONIAL LIFE AND ACCIDENT INS | $288 | $17 | $305 | 1.48% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INS | $236 | $68 | $304 | 1.47% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INS | $120 | $15 | $135 | 0.65% |
| CALIFORNIA INSURANCE ADVOCATES INC3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INS | $88 | $1 | $89 | 0.43% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE AND ACCIDENT INS | $71 | $0 | $71 | 0.34% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R AND B ENROLLMENT SERVICES INC | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INS | $59 | $8 | $67 | 0.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 3310 SANTA BARBARA, CA 93130 | COLONIAL LIFE AND ACCIDENT INS | $62 | $0 | $62 | 0.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | SAFEGUARD HEALTH PLANS, INC. | $844 | $97 | $941 | 15.27% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 196 | $1.2M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE CO | 226 | $108K |
| Vision | BLUE CROSS OF CALIFORNIA | 196 | $818K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 226 | $896K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 196 | $1.2M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 226 | $917K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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."
No prospect flags tripped on this filing.