| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 4047 CONCORD, CA 94524 | BLUE CROSS OF CALIFORNIA | $63K | $5K | $68K | 6.08% |
| TOLMAN AND WIKER INS. SVCS., LLC3 Filed as: TOLMAN & WIKER INSURANCE SERVICES | 196 SOUTH FIR STREET VENTURA, CA 93002 | BLUE CROSS OF CALIFORNIA | $8 | $0 | $8 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | DEAN HEALTH PLAN INC | $18K | $0 | $18K | 5.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $0 | $9K | 14.15% |
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 | 318 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 221 | $1.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 221 | $1.1M |
| Vision | BLUE CROSS OF CALIFORNIA | 221 | $1.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 318 | $67K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 318 | $67K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 221 | $1.4M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 318 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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.