| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 0.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $8K | $604 | $8K | 0.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 8.66% |
| ADVANCED BENEFIT CONSULTING3 | P.O. BOX 6677 FULLERTON, CA 92834 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 6.05% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 19840 N PIMA ROAD SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 4.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $211 | $4K | 28.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 4695 MACARTHUR COURT, SUITE 600 NEWPORT BEACH, CA 92660 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $247 | — | $247 | 5.01% |
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 | 1,682 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,683 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,515 | $3.9M |
| Dental | BLUE CROSS OF CALIFORNIA | 1,608 | $1.3M |
| Vision | BLUE CROSS OF CALIFORNIA | 1,608 | $1.3M |
| Life insurance(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 1,608 | $1.4M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 88 | $87K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,515 | $3.9M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 1,608 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,515 | — |
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.