| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | $10K | $14K | $24K | 0.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $5K | $10K | $15K | 2.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $7K | — | $7K | 1.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 5601 EAST LA PALMA ANAHEIM, CA 92801 | AETNA LIFE INSURANCE COMPANY | — | $147 | $147 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | STANDARD INSURANCE COMPANY | $50K | $4K | $54K | 15.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 180 RIVER ROAD, 2ND FLOOR SUMMIT, NJ 07901 | STANDARD INSURANCE COMPANY | — | $7K | $7K | 2.03% |
| RICHARD B HUBER3 Filed as: RICHARD B. HUBER | PO BOX 501623 SAN DIEGO, CA 92150 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 9.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 25186 HANCOCK AVENUE, SUITE 200 MURRIETA, CA 95262 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $455 | $7K | 7.70% |
| JEFFREY P. RABBETTS3 Filed as: JEFFREY RABBETTS | 19240 BOX CANYON ROAD CORONA, CA 92881 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 4.78% |
| RICHARD BLAINE HUBER3 | PO BOX 7220 REDLANDS, CA 92375 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $96 | — | $96 | 11.93% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI AND ASSOC. INS. SVCS. | 2400 WEST MINERAL KING AVENUE SUITE B VISALIA, CA 93291 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9 | — | $9 | 1.12% |
| NATIONAL BENEFIT PARTNERS3 | 23282 MILL CREEK DRIVE, SUITE 390 LAGUNA HILLS, CA 92653 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.37% |
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 | 661 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 666 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 1,244 | $5.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,580 | $620K |
| Vision | STANDARD INSURANCE COMPANY | 778 | $353K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 778 | $439K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 778 | $439K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 778 | $439K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 1,244 | $5.6M |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 778 | $440K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,580 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.