| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC | 820 GESSNER ROAD SUITE 1825 HOUSTON, TX 77024 | CIGNA HEALTHCARE OF CALIFORNIA | $150K | — | $150K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | $7K | $19K | 0.61% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC | 820 GESSNER ROAD SUITE 1825 HOUSTON, TX 77024 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $3K | $3K | 0.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | P.O. BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $115K | $16K | $132K | 14.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | P.O. BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | — | $80 | $80 | 0.01% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC | 820 GESSNER ROAD SUITE 1825 HOUSTON, TX 77024 | METROPOLITAN LIFE INSURANCE COMPANY | -$956 | — | -$956 | -0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | RELIASTAR LIFE INSURANCE COMPANY | $18K | — | $18K | 12.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | MANAGED HEALTH NETWORK | $4K | — | $4K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA | $1K | — | $1K | 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 | 1,692 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,706 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 1,438 | $7.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,265 | $1.3M |
| Vision | VISION SERVICE PLAN | 1,393 | $193K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,266 | $934K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,266 | $934K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,266 | $934K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 776 | $6.9M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,266 | $981K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,265 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.