| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $204K | $204K | 3.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | KAISER FOUNDATION HEALTH PLAN INC | $135K | $0 | $135K | 3.45% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $1K | $1K | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN SAN JOSE, CA 95110 | DELTA DENTAL OF CALIFORNIA | $79K | $0 | $79K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3000 EXECUTIVE PARKWAY, SUITE 300 SAN RAMON, CA 94583 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $26K | $0 | $26K | 5.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $12K | $0 | $12K | 10.00% |
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 | 888 | 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) | 889 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 727 | $9.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,483 | $793K |
| Vision | VISION SERVICE PLAN | 795 | $116K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 890 | $453K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 890 | $453K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 890 | $453K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 727 | $9.3M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 890 | $453K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,483 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.