| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | $62K | $0 | $62K | 6.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 4047 CONCORD, CA 94524 | KAISER FOUNDATION HEALTH PLAN INC | $30K | $0 | $30K | 7.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $781 | $781 | 0.18% |
| ALGENTIS, LLC3 | 333 WEST EL CAMINO REAL, SUITE 330 SUNNYVALE, CA 94087 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $0 | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $14K | $0 | $14K | 6.82% |
| ALEGENTIS, LLC3 | 333 WEST EL CAMINO REAL SUNNYVALE, CA 94087 | VISION SERVICE PLAN | $1K | $0 | $1K | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | DELTA DENTAL OF CALIFORNIA | $14K | $0 | $14K | 6.82% |
| ALGENTIS, LLC3 | 333 WEST EL CAMINO REAL SUNNYVALE, CA 94087 | DELTA DENTAL OF CALIFORNIA | $1K | $0 | $1K | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 11.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 5375 MIRA SORRENTO PLACE, SUITE 400 SAN DIEGO, CA 92121 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 5375 MIRA SORRENTO PLACE, SUITE 400 SAN DIEGO, CA 92121 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $759 | $759 | 1.68% |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 170 | $1.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 118 | $208K |
| Vision | VISION SERVICE PLAN | 118 | $208K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 119 | $45K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 119 | $45K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 170 | $1.4M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 119 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.