| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3635 RIVERSIDE PLAZA DRIVE BLDG M3 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE COMPANY | $170K | — | $170K | 3.33% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INS SOLUTIONS INC | 5375 MIRA SORRENTO PLACE #400 SAN DIEGO, CA 92121 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $22K | $22K | 0.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 5405 MOREHOUSE DRIVE #340 SAN DIEGO, CA 92121 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $2K | $2K | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL INS SVCS INC | 3635 RIVERSIDE PLAZA DRIVE BLDG M3 RIVERSIDE, CA 92506 | UNITEDHEALTHCARE INSURANCE COMPANY | $62K | — | $62K | 3.53% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INS SOLUTIONS INC | 5375 MIRA SORRENTO PLACE #400 SAN DIEGO, CA 92121 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $8K | $8K | 0.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL INS SVCS INC | 5405 MOREHOUSE DRIVE #340 SAN DIEGO, CA 92121 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $505 | $505 | 0.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $106K | $24K | $130K | 9.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIF INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | DELTA DENTAL OF CALIFORNIA | $18K | — | $18K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIF INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | DELTA DENTAL OF CALIFORNIA | $12K | — | $12K | 10.00% |
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 | 522 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 522 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 800 | $6.9M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 336 | $481K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 768 | $1.3M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 768 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 800 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.