| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TAS INSURANCE SERVICES INC3 | 8941 ATLANTA AVE STE 359 HUNTINGTON BEACH, CA 92646 | AETNA HEALTH OF CALIFORNIA INC. | $24K | — | $24K | 2.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | 3390 UNIVERSITY AVE, SUITE 300 RIVERSIDE, CA 92501 | AETNA HEALTH OF CALIFORNIA INC. | $20K | — | $20K | 2.25% |
| TAS INSURANCE SERVICES INC3 | 8941 ATLANTA AVE STE 359 HUNTINGTON BEACH, CA 92646 | AETNA LIFE INSURANCE COMPANY | $6K | — | $6K | 4.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | 3390 UNIVERSITY AVE, SUITE 300 RIVERSIDE, CA 92501 | AETNA LIFE INSURANCE COMPANY | $5K | — | $5K | 3.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 3.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | HARTFORD LIFE AND ACCIDENT | $483 | — | $483 | 1.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 8941 ATLANTA AVE STE 359 HUNTINGTON BEACH, CA 92646 | HARTFORD LIFE AND ACCIDENT | $415 | — | $415 | 1.16% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 193 | $1.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 193 | $131K |
| Vision | AETNA LIFE INSURANCE COMPANY | 193 | $131K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 167 | $36K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 193 | $1.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 167 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.