| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCES. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $52K | $2K | $54K | 5.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $3K | $1K | $5K | 6.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | BLUE CROSS OF CALIFORNIA | $2K | $0 | $2K | 2.15% |
| ROBERT D AHEARN3 Filed as: ROBERT D. AHEARN | 13646 MORNINGSIDE DRIVE YUCAIPA, CA 92399 | AFLAC | $3K | $124 | $3K | 10.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 2393 TOWNSGARE ROAD, SUITE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $2K | $0 | $2K | 6.83% |
| MARIAN E LENCIONI3 Filed as: MARIAN E. LENCIONI | 1109 WEST 9TH STREET UPLAND, CA 91786 | AFLAC | $731 | $25 | $756 | 2.81% |
| MJ INSURANCE3 Filed as: MARIAN LENCIONI AND VARIOUS AGENTS | 3400 INLAND EMPIRE BOULEVARD SUITE 101 ONTARIO, CA 91764 | AFLAC | $706 | $0 | $706 | 2.63% |
| DAVID J REESOR3 Filed as: DAVID J. REESOR | 2220 EAST ROUTE 66, SUITE 215 GLENDORA, CA 91740 | AFLAC | $665 | $25 | $690 | 2.57% |
| STEPHANIE J SCHLAF3 Filed as: STEPHANIE J. SCHLAF | 155 NORTH RIVERVIEW DRIVE SUITE 110 ANAHEIM, CA 92808 | AFLAC | $486 | $0 | $486 | 1.81% |
| PATRICK J SCHLAF3 Filed as: PATRICK J. SCHLAF | 155 NORTH RIVERVIEW DRIVE SUITE 110 ANAHEIM, CA 92808 | AFLAC | $384 | $0 | $384 | 1.43% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 211 | $978K |
| Dental | BLUE CROSS OF CALIFORNIA | 207 | $74K |
| Vision | BLUE CROSS OF CALIFORNIA | 207 | $74K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 207 | $101K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 211 | $978K |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 207 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.