| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | KAISER FOUNDATION HEALTH PLAN INC | $61K | $0 | $61K | 4.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 255387 SACRAMENTO, CA 95865 | SUTTER HEALTH PLAN | $32K | $0 | $32K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | UNKNOWN RIVERSIDE, CA 92501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $49K | $0 | $49K | 16.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | PO BOX 803 LOS ALAMOS, CA 93440 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 11.69% |
| ENROLLEASE3 | 660 YORK STREET, SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $330 | $0 | $330 | 0.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.56% |
| THE AGURS GROUP INC.4 Filed as: THE AGURS GROUP INC | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $102 | $0 | $102 | 3.75% |
| MATT MORRIS4 | 21344 EAST CHIMNEY LANE LIBERTY LAKE, WA 99019 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $75 | $0 | $75 | 2.76% |
| TBG SOLUTIONS INC4 | PO BOX 8421 TYLER, TX 75711 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $27 | $0 | $27 | 0.99% |
| JEREMY A. GOMEZ4 Filed as: JEREMY A GOMEZ | 42612 CLIFFORD STREET, SUITE B PALM DESERT, CA 92260 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $25 | $0 | $25 | 0.92% |
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 | 214 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 141 | $2.0M |
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 216 | $288K |
| Vision | VISION SERVICE PLAN | 186 | $35K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 216 | $288K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 216 | $70K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 216 | $288K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 141 | $2.0M |
| Other(4 contracts, 4 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 216 | $372K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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.