| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS | PO BOX 3310 SANTA BARBARA, CO 93130 | BLUE CROSS OF CALIFORNIA | $46K | $40K | $85K | 2.95% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE INC | 160 FEDERAL ST BOSTON, MA 01982 | BLUE CROSS OF CALIFORNIA | $84K | — | $84K | 2.89% |
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BLVD STE 300 BURLINGAME, CA 94010 | PRINCIPAL LIFE INSURANCE COMPANY | $25K | — | $25K | 7.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 6701 CENTER DR W STE 1500 LOS ANGELES, CA 90045 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 2.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMTED | 300 N LA SALLE DR FL 17 CHICAGO, IL 60654 | PRINCIPAL LIFE INSURANCE COMPANY | — | $8K | $8K | 2.31% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST BOSTON, MA 02110 | UNUM | $9K | $2K | $11K | 7.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM | $3K | — | $3K | 2.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATINAL OF CA INSURANCE | STE 300 3390 UNIVERSITY AVE RIVERSIDE, CA 92501 | UNUM | — | $635 | $635 | 0.43% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC | 160 FEDERAL STREET BOSTON, MA 02110 | EYEMED | $2K | — | $2K | 5.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL-CENTER DR | 3390 UNIVERSITY AVE #300 RIVERSIDE, CA 92501 | EYEMED | $1K | — | $1K | 4.42% |
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 | 202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 198 | $2.9M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 394 | $334K |
| Vision | EYEMED | 373 | $32K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 394 | $334K |
| Short-term disability | UNUM | 202 | $149K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 394 | $483K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.