| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | AETNA HEALTH OF CALIFORNIA INC. | $42K | — | $42K | 4.99% |
| LEBHERZ INSURANCE SERVICES INC3 Filed as: LEBHERZ INSURANCE SERVICES INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | AETNA HEALTH OF CALIFORNIA INC. | $17K | — | $17K | 1.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | $61 | $3K | 4.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $471 | $8K | 10.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| LEBHERZ INSURANCE SERVICES INC3 Filed as: LEBHERZ INSURANCE SERVICES INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | AETNA LIFE INSURANCE COMPANY | $630 | — | $630 | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $2K | $6K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $969 | $4K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE | $970 | — | $970 | 9.04% |
| FLEXVISION - MD3 | 15400 CALHOUN DRIVE, SUITE 125 ROCKVILLE, MD 20855 | EYEMED VISION CARE | $537 | — | $537 | 5.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $832 | $277 | $1K | 19.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $254 | $85 | $339 | 20.02% |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 141 | $959K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 104 | $75K |
| Vision | EYEMED VISION CARE | 131 | $11K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 112 | $31K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 35 | $6K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 108 | $19K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 141 | $959K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 112 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.