| 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 | KAISER FOUNDATION HEALTH PLAN INC | $23K | — | $23K | 6.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | — | $475 | $475 | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AETNA HEALTH, INC. | $6K | — | $6K | 5.10% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | AETNA HEALTH, INC. | $2K | — | $2K | 2.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE CO. | $4K | — | $4K | 5.96% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | AETNA LIFE INSURANCE CO. | $1K | — | $1K | 2.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCES., INC. | PO BOX 3018 BOTHELL, WA 98041 | AETNA LIFE INSURANCE CO. | — | $139 | $139 | 0.21% |
| UNKNOWN3 | UNKNOWN CERRITOS, CA 90703 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $294 | — | $294 | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $147 | $147 | 4.99% |
| DAILYFEATS INC.3 Filed as: DAILYFEATS INC | 131 TREMONT STREET, 3RD FLOOR BOSTON, MA 02111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $59 | — | $59 | 2.00% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 62 | $525K |
| Dental | DELTA DENTAL OF CALIFORNIA | 74 | $30K |
| Vision | AETNA LIFE INSURANCE CO. | 56 | $66K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 128 | $69K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 62 | $525K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 128 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.