| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 255387 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $57K | $0 | $57K | 4.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 255387 SACRAMENTO, CA 95865 | SUTTER HEALTH PLAN | $26K | $0 | $26K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN RIVERSIDE, CA 92501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $39K | $0 | $39K | 14.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 11.60% |
| ENROLLEASE3 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $727 | $0 | $727 | 0.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 5345 RIVERSIDE, CA 92517 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.19% |
| 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 | $107 | $0 | $107 | 3.52% |
| MATT MORRIS4 | 21344 EAST CHIMNEY LANE LIBERTY LAKE, WA 99019 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $100 | $0 | $100 | 3.29% |
| JEREMY A. GOMEZ3 Filed as: JEREMY GOMEZ | 42612 CLIFFORD STREET, SUITE B PALM DESERT, CA 92260 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $21 | $0 | $21 | 0.69% |
| XHRISTOPHER B. GAUKLER4 | 38592 WINDINGWALK DRIVE MURRIETA, CA 92563 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $21 | $0 | $21 | 0.69% |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 160 | $1.7M |
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 223 | $264K |
| Vision | VISION SERVICE PLAN | 198 | $34K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 223 | $264K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 223 | $79K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 223 | $264K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 160 | $1.7M |
| Other(4 contracts, 4 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 223 | $352K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.