| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $45K | $0 | $45K | 4.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $1K | $1K | 0.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | SUTTER HEALTH PLAN | $23K | $0 | $23K | 5.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $34K | $0 | $34K | 14.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $4K | 8.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.03% |
| 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 | $251 | $0 | $251 | 4.70% |
| MATT MORRIS4 | 21344 EAST CHIMMEY LANE LIBERTY LAKE, WA 99019 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $186 | $0 | $186 | 3.48% |
| LINDA J. CASH4 | 3430 TULLY ROAD, SUITE 20-426 MODESTO, CA 95350 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $40 | $0 | $40 | 0.75% |
| GRACE S. COTA4 | 7342 PATERO CIRCLE SACRAMENTO, CA 95823 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $31 | — | $31 | 0.58% |
| JEREMY A. GOMEZ4 | 43805 MONTEREY AVENUE, SUITE 24 PALM DESERT, CA 92260 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $25 | $0 | $25 | 0.47% |
| CHRISTOPHER B GAUKLER4 Filed as: CHRISTOPHER B. GAUKLER | 38592 WINDINGWALK DRIVE MURRIETA, CA 92563 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $25 | $0 | $25 | 0.47% |
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 | 188 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 205 | 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 | $1.4M |
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 188 | $235K |
| Vision | VISION SERVICE PLAN | 159 | $28K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 188 | $235K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 186 | $40K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 188 | $235K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 141 | $1.4M |
| Other(3 contracts, 3 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 188 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.