| 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 | BLUE SHIELD OF CALIFORNIA | $0 | $191K | $191K | 3.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | KAISER FOUNDATION HEALTH PLAN, INC. | $156K | $17 | $156K | 3.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | UNKNOWN SAN JOSE, CA 95110 | DELTA DENTAL OF CALIFORNIA | $90K | $0 | $90K | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $54K | $0 | $54K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $12K | $12K | 3.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | $13K | $0 | $13K | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 255387 SACRAMENTO, CA 95865 | UNUM INSURANCE COMPANY | $7K | $0 | $7K | 17.56% |
| BENEFIT EDUCATORS LLC3 | 2516 WAUKEGAN ROAD, SUITE 357 GLENVIEW, IL 60025 | UNUM INSURANCE COMPANY | $6K | $0 | $6K | 16.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNUM INSURANCE COMPANY | $0 | $592 | $592 | 1.54% |
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 | 839 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 845 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 720 | $11.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,504 | $897K |
| Vision | VISION SERVICE PLAN | 792 | $132K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 831 | $361K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 831 | $361K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 831 | $361K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 720 | $11.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 831 | $399K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,504 | — |
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.