| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | P.O. BOX 3310 SANTA BARBARA, CA 93130 | ANTHEM BLUE CROSS | $27K | $8K | $36K | 0.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN | $134K | $4K | $138K | 3.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN | $38K | $1K | $39K | 3.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE | P.O. BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE | $87K | $9K | $96K | 15.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES | P.O. BOX 5345 RIVERSIDE, CA 93517 | VISION SERVICE PLAN | $29K | — | $29K | 10.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | SAFEGUARD HEALTH PLANS INC. | $14K | $1K | $16K | 15.48% |
| PHRI LLC3 Filed as: PHRI, LLC | 35 PARKWOOD DRIVE SUITE 200 HOPKINGTON, MA 01748 | NATIONAL GUARDIAN LIFE INSURANCE | $10K | — | $10K | 70.00% |
| EMPLICITY INSURANCE SERVICES3 Filed as: EMPLICITY INSURANCE SERVICES, INC. | 9851 IRVINE CENTER DRIVE SUITE 200 IRVINE, CA 92618 | NATIONAL GUARDIAN LIFE INSURANCE | $4K | $0 | $4K | 30.00% |
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 | 1,364 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | ANTHEM BLUE CROSS | 2,245 | $9.8M |
| Dental(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 2,245 | $5.9M |
| Vision(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 2,245 | $5.6M |
| Life insurance | ANTHEM BLUE CROSS | 2,245 | $5.3M |
| Short-term disability | ANTHEM BLUE CROSS | 2,245 | $5.3M |
| Long-term disability | ANTHEM BLUE CROSS | 2,245 | $5.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,245 | — |
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.