| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $65K | $65K | 3.88% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE | $6K | $25K | $31K | 1.87% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 2.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 255387 SACRAMENTO, CA 95865 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.55% |
| 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 | $6K | $0 | $6K | 3.93% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $0 | $2K | 1.22% |
| BEERE & PURVES INC3 Filed as: BEERE AND PURVES INC | 500 YGNACIO VALLEY ROAD, SUITE 450 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 0.95% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $5K | $7K | 6.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $66 | $2K | 1.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $673 | $673 | 0.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 701 UNIVERSITY AVENUE, SUITE 100 SACRAMENTO, CA 95825 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | $0 | $1K | 6.52% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CRICLE SUITE 180 LARKSPUR, CA 94939 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $584 | $0 | $584 | 3.47% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 227 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 467 | $112K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 302 | $17K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $341K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $341K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $341K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 227 | $1.8M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $341K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.