| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4371 LATHAM ST STE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | — | $1K | $1K | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DEIGO, CA 92121 | HARTFORD LIFE AND ACCIDENT | $33K | — | $33K | 10.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | HARTFORD LIFE AND ACCIDENT | — | $10K | $10K | 3.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | 970 RESERVE DR SUITE 200 ROSEVILLE, CA 95678 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 N RIVERSIDE PLZ STE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $10K | $10K | 3.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3801 UNIVERSITY AVE STE 400 RIVERSIDE, CA 92501 | RELIASTAR LIFE INSURANCE COMPANY | $52K | — | $52K | 18.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 600 CORPORATE POINTE CULVER CITY, CA 90230 | RELIASTAR LIFE INSURANCE COMPANY | — | $9K | $9K | 3.18% |
| SYNERGY ENROLLMENT & BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS | PO BOX 210234 CHULA VISTA, CA 91921 | TRUSTMARK INSURANCE COMPANY | $406 | — | $406 | 6.30% |
| MARSH & MCLENNAN AGENCY LLC3 | 1 POLARIS WAY SUITE 300 ALISO VIEJO, CA 92565 | TRUSTMARK INSURANCE COMPANY | $174 | — | $174 | 2.70% |
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 | 1,190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 548 | $5.8M |
| Dental(2 contracts, 2 carriers) | SIMNSA | 896 | $992K |
| Vision | VISION SERVICE PLAN | 548 | $58K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,433 | $315K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 790 | $277K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,433 | $309K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 548 | $5.8M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,433 | $585K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,433 | — |
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."
No prospect flags tripped on this filing.