| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | UNITED HEALTHCARE INSURANCE COMPANY | $25K | — | $25K | 5.46% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC CALIFORNIA | 669 RIVER DRIVE CENTER II STE 305 ELMWOOD PARK, NJ 07407 | UNITED HEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 1.11% |
| ROGERS BENEFIT GROUP INC3 | 2251 DOUGLAS BLVD, SUITE 115 ROSEVILLE, CA 95661 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 0.98% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DR, SUITE 250 IRVINE, CA 92618 | UNITED HEALTHCARE INSURANCE COMPANY | $35 | — | $35 | 0.01% |
| MATTHEW WILLIAM SHEPARD3 | 4786 MISSION BLVD SAN DIEGO, CA 92121 | UNITED HEALTHCARE INSURANCE COMPANY | $21 | — | $21 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | MEDIEXCEL HEALTH PLAN | $6K | — | $6K | 5.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | DENTAL HEALTH SERVICES | $2K | — | $2K | 9.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92506 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 65 | $561K |
| Dental(2 contracts, 2 carriers) | MEDIEXCEL HEALTH PLAN | 74 | $136K |
| Vision(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 65 | $561K |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 98 | $14K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 65 | $561K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 98 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 98 | — |
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.